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Osmotic demyelination syndrome in a 44-year-old man with severe hyponatremia (3)

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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. Diffusion-weighted imaging (DWI) on hospital day 12 showed that the previous lesions of the caudate nucleus and putamen had become more conspicuous, and a new high intensity lesion was then evident, involving the central pons and consistent with central pontine myelinolysis. (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.)