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Osmotic demyelination syndrome in a 44-year-old man with severe hyponatremia (2)

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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 symmetrical high-intensity lesions at the head of caudate nucleus and putamen. (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.)