Publication:

Extrapontine myelinolysis in severe hypernatremia despite controlled sodium correction: a case report

Osmotic demyelination syndrome (ODS) is a condition characterized by sudden loss of myelin, typically triggered by rapid shifts in the body's osmotic balance. We report a 53-year-old male with recurrent carcinoma of the buccal mucosa who developed severe hypernatremia following sodium bicarbonate infusion. Despite careful and gradual correction of his elevated sodium levels, he subsequently developed quadriparesis, and MRI confirmed extrapontine myelinolysis. Supportive neurological, oncological, and hematological care was provided, but the patient ultimately succumbed to his illness. This case highlights that even cautious correction of sodium disturbances can precipitate ODS, particularly in patients with malignancy and metabolic stress, emphasizing the need for vigilant monitoring and individualized management.