Osmotic demyelination syndrome

Case contributed by Paresh K Desai
Diagnosis almost certain


Suspicion of metabolic encephalopathy

Patient Data

Age: 60 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

MRI brain reveals central pontine hyperintensity on T2/FLAIR.

In addition there is symmetric hyperintensity of the thalami, caudate nuclei and the lentiform nuclei. There is no diffusion restriction.

Cerebellum and the rest of the cortex and subcortical white matter are normal.


Suspicion of osmotic demyelination syndrome (central pontine and extrapontine myelinolysis).

Case Discussion

MRI diagnosis is osmotic demyelination syndrome (central pontine and extrapontine myelinolysis).

Patient was detected to be having hyponatremia with subsequent correction 2 weeks ago.

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