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Osmotic Demyelination Syndrome as the Initial Manifestation of a Hyperosmolar Hyperglycemic State
Joint Authors
Zapata-Rivera, Maria Azucena
Rodríguez-Velver, Karla Victoria
Soto-Garcia, Analy J.
Villarreal-Pérez, Jesús Zacarías
Rodríguez-Gutiérrez, René
Montes-Villarreal, Juan
Source
Case Reports in Neurological Medicine
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-11-09
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Osmotic demyelination syndrome (ODS) is a life-threatening demyelinating syndrome.
The association of ODS with hyperosmolar hyperglycemic state (HHS) has been seldom reported.
The aim of this study was to present and discuss previous cases and the pathophysiological mechanisms involved in ODS secondary to HHS.
A 47-year-old man arrived to the emergency room due to generalized tonic-clonic seizures and altered mental status.
The patient was lethargic and had a Glasgow coma scale of 11/15, muscle strength was 4/5 in both lower extremities, and deep tendon reflexes were diminished.
Glucose was 838 mg/dL; serum sodium and venous blood gas analyses were normal.
Urinary and plasma ketones were negative.
Brain magnetic resonance revealed increased signal intensity on T2-weighted FLAIR images with restricted diffusion on the medulla and central pons.
Supportive therapy was started and during the next 3 weeks the patient progressively regained consciousness and muscle strength and was able to feed himself.
At 6-month follow-up, the patient was asymptomatic and MRI showed no residual damage.
In conclusion, the association of ODS with HHS is extremely rare.
The exact mechanism by which HHS produces ODS still needs to be elucidated, but we favor a rapid hypertonic insult as the most plausible mechanism.
American Psychological Association (APA)
Rodríguez-Velver, Karla Victoria& Soto-Garcia, Analy J.& Zapata-Rivera, Maria Azucena& Montes-Villarreal, Juan& Villarreal-Pérez, Jesús Zacarías& Rodríguez-Gutiérrez, René. 2014. Osmotic Demyelination Syndrome as the Initial Manifestation of a Hyperosmolar Hyperglycemic State. Case Reports in Neurological Medicine،Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-1034827
Modern Language Association (MLA)
Rodríguez-Velver, Karla Victoria…[et al.]. Osmotic Demyelination Syndrome as the Initial Manifestation of a Hyperosmolar Hyperglycemic State. Case Reports in Neurological Medicine No. 2014 (2014), pp.1-5.
https://search.emarefa.net/detail/BIM-1034827
American Medical Association (AMA)
Rodríguez-Velver, Karla Victoria& Soto-Garcia, Analy J.& Zapata-Rivera, Maria Azucena& Montes-Villarreal, Juan& Villarreal-Pérez, Jesús Zacarías& Rodríguez-Gutiérrez, René. Osmotic Demyelination Syndrome as the Initial Manifestation of a Hyperosmolar Hyperglycemic State. Case Reports in Neurological Medicine. 2014. Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-1034827
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1034827