Article Text
Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Treatment response in osmotic demyelination syndrome presenting as severe parkinsonism, ptosis and gaze palsy
Summary
Osmotic demyelination syndrome commonly affects the pons and infrequently involves the extrapontine region. We report a patient with severe hyponatraemia who developed osmotic demyelination syndrome as a consequence of rapid sodium correction. The condition manifested as acute severe parkinsonism, bilateral ptosis and gaze impairment. MRI revealed typical features of central pontine and extrapontine myelinolysis. The patient improved gradually after treatment with a combination of levodopa, intravenous immunoglobulin and dexamethasone. However, it is important to emphasise that the improvement of neurological symptoms is not necessarily causal with these experimental therapies.
- brain stem / Cerebellum
- fluid electrolyte and acid-base disturbances
- unwanted effects / adverse reactions
- parkinson’s disease