Abstract
Background: The authors report serial magnetic resonance imaging findings of osmotic demyelination syndrome (ODS) related to hyperglycemia in a patient with uncontrolled diabetes mellitus.
Case presentation: A 61-year-old man with diabetes was admitted for general weakness and severe thirst. A few days later, he complained of dysarthria, dysphasia, and dysmetria. On admission, he exhibited significant hyperglycemia (33.5 mmol/L [627 mg/dL]), with a glycated hemoglobin level of 18.1%. Other laboratory investigations revealed a sodium level of 133 mEq/L, potassium 3.8 mEq/L, blood urea nitrogen 43.9 mg/dL, with a calculated serum osmolality of 324 mOsm/kg. Brain magnetic resonance imaging (MRI) revealed T2 signal abnormalities that were symmetrical, non-space occupying, and located in the central pons with a peripheral sparing pattern, which were findings suggestive of ODS. In addition, subsequent MRI revealed progression of signal hyperintensity; however, the patient's symptoms were improved and he was discharged after 2 months.
Conclusion: We report a rare case of hyperglycemia-related ODS that exhibited gradual progression in imaging features despite the prompt correction of blood sugar levels and improvement of neurological symptoms
Serial Magnetic Resonance Imaging Findings of Rasmussen''s Encephalitis —Case Report—
