Yadav Sushil Kumar, Ojha Rajeev, Parajuli Naresh, Karki Susmin, Pant Sobin, Karn Ragesh, Gajurel Bikram Prasad, Rajbhandari Reema, Gautam Niraj, Shrestha Ashish, Jha Anamika
Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
SAGE Open Med Case Rep. 2022 Nov 1;10:2050313X221135595. doi: 10.1177/2050313X221135595. eCollection 2022.
Osmotic demyelination syndrome is a rare condition reported mainly in the case of rapid correction of hyponatremia, but it can occur even in the case of complicated diabetes mellitus either during rapid correction of hyperglycemia or anytime during the complicated diabetes mellitus. We report a case of complicated diabetes mellitus developing osmotic demyelination syndrome. The patient had presented with altered sensorium and seizure, which was initially diagnosed as hyperglycemia, but during his treatment, the magnetic resonance imaging of brain revealed central pontine myelinolysis. Our search on the causes of osmotic demyelination syndrome other than rapid correction of hyponatremia has revealed several other causes like autoimmune liver disease, Sjogren's syndrome and non-Hodgkin's lymphoma in addition to diabetes mellitus.
渗透性脱髓鞘综合征是一种罕见疾病,主要报道于低钠血症快速纠正的情况下,但在糖尿病并发症患者中,无论是在高血糖快速纠正期间还是糖尿病并发症的任何阶段都可能发生。我们报告一例糖尿病并发症患者发生渗透性脱髓鞘综合征的病例。该患者出现意识改变和癫痫发作,最初被诊断为高血糖,但在治疗过程中,脑部磁共振成像显示为中枢性脑桥髓鞘溶解症。我们对除低钠血症快速纠正之外的渗透性脱髓鞘综合征病因进行的研究发现,除糖尿病外,还有其他几种病因,如自身免疫性肝病、干燥综合征和非霍奇金淋巴瘤。