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Osmotic demyelination syndrome in a 44-year-old man with severe hyponatremia (1)

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(100 mmol/L) This 44-year-old man was treated with sodium supplementation with 3% hypertonic saline and water restriction and developed altered mental status with agitation, limb rigidity, bradykinesia, and dystonia on hospital day 2. The initial MRI at that time showed no significant abnormalities on FLAIR (A) and T2-weighted images (B). (Source: Lee C, Ko C. Temporal brain MRI changes from extrapontine myelinolysis to central pontine myelinolysis: a case report. Cureus 2021;13[11]:e19318. Creative Commons Attribution license [CC BY], https://creativecommons.org/licenses/by/4.0.)