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Osmotic demyelination syndrome
https://doi.org/10.30629/2658-7947-2024-29-5-4-12
Abstract
Introduction. Osmotic demyelinating syndrome(ODS) is a life-threatening condition caused by water and electrolyte disturbances, usually associated with rapid correction of hyponatremia, manifested by acute demyelination of the brain. The average age of development of patients with ODS varies from 30 to 50 years. The incidence of unfavorable outcome (mortality/complete dependence on outside help) varies from 33 to 55%.
Objective. Systematization of data on the etiology, pathophysiology, clinical manifestations, diagnosis and treatment of osmotic demyelinating syndrome.
Material and methods. The literature search was performed in the electronic search engines Scopus, eLibrary, PubMed using the keywords: osmotic demyelinating syndrome, central pontine myelinolysis, extrapontine myelinolysis. Scientific articles published between 1959 and 2024 were selected for analysis.
Results. The main reason for the development of ODS is water and electrolyte disturbances that occur secondary to severe somatic pathology. Clinical manifestations of ODS are intermittent. Сlinical improvement is typical after rapid correction of osmolarity, followed by the development after 3–5 days of a clinical picture of acute myelinolysis. Currently, there is no specific therapy for ODS. However, early diagnosis of this disease is extremely important due to the high incidence of disorders of consciousness and breathing that require artificial ventilation. The polymorphism of clinical symptoms, as well as the low awareness of doctors, complicate the diagnosis and timely initiation of therapy for ODS. The optimal method of neuroimaging in patients with ODS is MRI in DWI, T2 and T2 FLAIR modes. The rate of correction of hyponatremia by no more than 10 mmol/l in the first 24 hours and no higher than 8 mmol/l every subsequent day is the main way to prevent the development of ODS.
About the Authors
G. R. Ramazanov
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Moscow
E. A. Kovaleva
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Moscow
K. R. Akchurina
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Moscow
M. E. Bykova
Russian University of Medicine
Russian Federation
Russian Federation
Moscow
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Review
For citations:
Ramazanov G.R., Kovaleva E.A., Akchurina K.R., Bykova M.E. Osmotic demyelination syndrome. Russian neurological journal. 2024;29(5):4-12. (In Russ.) https://doi.org/10.30629/2658-7947-2024-29-5-4-12
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