Incidence of osmotic demyelination syndrome in Sweden: A nationwide study.
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CitationIncidence of osmotic demyelination syndrome in Sweden: A nationwide study. 2019, Jul 25. doi: 10.1111/ane.13150 Acta Neurol Scand
AbstractOBJECTIVE: To report the incidence rate of osmotic demyelination syndrome (ODS), associated risk factors, treatment, and long-term outcomes in a nationwide cohort. METHODS: We conducted a retrospective study of individuals diagnosed with central pontine myelinolysis (ICD-10 code G37.2) in the Swedish National Patient Register during 1997-2011. RESULTS: During the study period, we identified 83 individuals with ODS, 47 women and 36 men. Median age at diagnosis was 55 years. The incidence rate of ODS for the entire study period was 0.611 (95% CI: 0.490-0.754) per million person-years and increased during the study period from 0.271 (95% CI: 0.147-0.460) in 1997-2001 to 0.945 (95% CI: 0.677-1.234) individuals per million person-years in 2007-2011. Most cases (86.7%) were hyponatremic with a median sodium level at admission of 104 mmol/L. All hyponatremic cases were chronic. The cause of hyponatremia was multifactorial, including drugs (56.9%), polydipsia (31.9%), and vomiting or diarrhea (41.7%). A majority of patients (69.9%) were alcoholics. Hyponatremic patients were predominantly treated with isotonic saline (93.1%) and only 4.2% with hypotonic fluids. The median correction rate was 0.72 mmol/L/h. Only six patients were corrected in accordance with national guidelines (≤8 mmol/L/24/h). At three months, 7.2% had died and 60.2% were functionally independent (modified Rankin Scale 0-2). INTERPRETATION: We found an increasing incidence during the study period, which could partly be explained by increased access to magnetic resonance imaging. ODS occurs predominantly in patients with extreme chronic hyponatremia which is corrected too fast with isotonic saline. Most patients survived and became functionally independent.
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- More often striatal myelinolysis than pontine? A consecutive series of patients with osmotic demyelination syndrome.
- Authors: de Souza A, Desai PK
- Issue date: 2012 Apr
- [Central and extrapontine myelinolysis following correction of extreme hyponatremia. Case report and review of the literature].
- Authors: Sveinsson OA, Pálsson R
- Issue date: 2008 Oct
- Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia.
- Authors: Lohr JW
- Issue date: 1994 May
- Central pontine myelinolysis with meticulous correction of hyponatraemia in chronic alcoholics.
- Authors: Malhotra K, Ortega L
- Issue date: 2013 Jun 21
- Central pontine and extrapontine myelinolysis after rapid correction of hyponatremia by hemodialysis in a uremic patient.
- Authors: Huang WY, Weng WC, Peng TI, Ro LS, Yang CW, Chen KH
- Issue date: 2007