Osmotic demyelination syndrome in Addison crisis and severe hyponatremia
Andersen, S.E.B.ød.; Stausbøl-Grøn, B.; Rasmussen, T.B.
Ugeskrift for Laeger 170(50): 4142
2008
ISSN/ISBN: 1603-6824 PMID: 19091197 Document Number: 621647
Acute adrenal insufficiency is a life threatening disease with dehydration, hypotension, cerebral dysfunction and gastrointestinal symptoms accompanied by low plasma sodium and high plasma potassium. Osmotic demyelination syndrome (ODS) can occur rarely following correction of plasma sodium. We describe a case with extremely low plasma sodium and subsequent development of ODS. Correction which is too slow may lead to cerebral oedema, brain stem herniation and low sodium encephalopathy. Correction which is too fast may cause ODS. The dilemma is accentuated by concomitant Addison crisis.