osmotic demyelination syndrome


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osmotic demyelination syndrome

(oz-mot'ik de-mi?e-li-na'shon)
Damage to the myelin sheaths that surround nerves, usually as a result of excessively rapid correction of very low serum sodium levels.

Patient care

It can be prevented by carefully monitoring serum sodium (Na+) concentrations when hyponatremic patients are rehydrated, limiting the increase in Na+ concentration to less than 10 meq/L in the first 24 hours, and 18meq/L in the first 2 days.

Synonym: myelinolysis
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References in periodicals archive ?
Osmotic demyelination syndrome often is preventable, with considerable morbidity and mortality.
Table 1 Risk factors for developing osmotic demyelination syndrome Advanced liver disease Alcoholism Hypokalemia Malnutrition Serum sodium concentration <105 mEq/L Source: Reference 6 Table 2 Expert panel recommendations: Avoiding ODS in patients with chronic hyponatremia Goal Minimum correction of serum sodium by 4 to 8 mEq/L per day, with a lower goal of 4 to 6 mEq/L per day if risk of ODS is high Limits not to exceed For high risk of ODS: 8 mEq/L in any 24-hour period For normal risk of ODS: 10-12 mEq/L In any 24-hour period; 18 mEq/L in any 48-hour period ODS: osmotic demyelination syndrome Source: Reference 6
Best cases from the AFIP: Osmotic demyelination syndrome.
Metabolic Osmotic demyelination syndrome Machiafava-Bignami Subacute combined degeneration 6.
COMMENT Avoiding osmotic demyelination syndrome requires careful treatment and monitoring.
Oligodendrocytes are particularly sensitive for osmotic changes therefore changes that are seen with osmotic demyelination syndrome are in distribution to oligodendroglial cells.