Osmotic Demyelination Syndrome in an Alcohol-Dependent Patient With Alcohol-Related Peripheral Neuropathy: A Case Report
Abstract
Osmotic demyelination syndrome (ODS) is a rare neurological disorder typically associated with rapid correction of hyponatremia, whereas alcohol-related peripheral neuropathy (ALN) is a common complication of chronic alcohol use. The coexistence of ODS and ALN is uncommon and may obscure timely diagnosis. We report the case of a 51-year-old man with a long-standing history of alcohol dependence who presented to the emergency department with vomiting and diarrhea persisting for six days. Laboratory tests revealed hyponatremia, macrocytic anemia, thrombocytopenia, and electrolyte imbalances. Neurological examination demonstrated distal paresthesia, diminished reflexes in the lower extremities, and positive Babinski and Chaddock signs. MRI revealed a hyperintense trident-shaped lesion in the pons consistent with ODS. These findings suggested the concomitant presence of ALN and ODS. The patient was treated conservatively with vitamin supplementation, careful correction of electrolytes, and gradual nutritional rehabilitation. Sodium levels normalized without the need for rapid correction, and the patient's symptoms improved, leading to discharge on the eighth hospital day. This case underscores two essential points: ODS was identified before any documented rapid in-hospital correction of hyponatraemia, and alcohol-dependent patients may present with overlapping features of ALN and ODS. Recognition of pyramidal signs is critical for differentiating central from peripheral…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.