Clinics in diagnostic imaging (45). Osmotic myelinolysis ( central potine myelinolysis)

A 65-year-old woman developed progressive neurological deterioration following rapid correction of hyponatremia. Magnetic resonance imaging showed T2 hyperintense areas in the central pons, basal ganglia and deep white matter, typical of osmotic myelinolysis (OM). Previously thought to be uniformly fatal, there are increasing reports of non-fatal cases of OM. The recognition and understanding of this entity is important to prevent or reduce the incidence of its occurrence, as there is no specific treatment once it develops. The clinical and radiological features of OM are reviewed.