Osmotic Demyelination Syndrome with Recent Chemotherapy in Normonatremic Patient: A Case Report

Osmotic demyelination syndrome (ODS), an acquired demyelinating disease of the central pons, was first described in 1959 by Adams et al. (1) in hyponatremic alcoholics. This disorder was formerly known as central pontine myelinolysis, extrapontine myelinolysis, or a combination of both (2). ODS has been classically defined as a symmetrical and selective destruction of myelin sheaths in the central portion of the basis pontis that typically occurs after rapid correction of hyponatremia (1, 3). However, ODS may develop in other medical conditions such as electrolyte imbalance, syndrome of inappropriate antidiuretic syndrome (SIADH), chronic renal failure, organ transplantation, and chemotherapy (3). Patients typically have various symptoms, ranging from mild neurologic symptoms to a complete locked-in syndrome, coma, or death (1-3). In this paper, we describe a case of ODS in a patient with normonatremia who recently received chemotherapy for colon cancer. We also performed relevant literature review on this disease.