{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:17:20Z","timestamp":1772068640107,"version":"3.50.1"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,4,3]]},"abstract":"<jats:p>A 44-year-old man presented with history of slurring of speech, slowness in activities, abnormal posturing of the upper limbs and drooling of saliva from the mouth. He had a 5-yearlong history of compulsive water drinking, consuming 12\u201315 L of water every day. He was earlier evaluated for the same and found to have low serum sodium (126\u2009mEq\/L). Presently, he was admitted at a primary care facility with fever and altered sensorium. He was found to have serum sodium of 94 mEq\/L. His sensorium improved with hypertonic saline infusion; however, after a lucid interval of 48\u2009hours, he developed florid extrapyramidal symptoms. Contrast-enhanced MRI brain revealed bilaterally symmetric T2-weighted fluid-attenuated inversion recovery hyperintensity in caudate and lentiform nuclei. A diagnosis of extrapontine myelinolysis with secondary parkinsonism was made. He improved significantly with levodopa therapy.<\/jats:p>\n               <jats:p>Psychogenic polydipsia is an important cause of hyponatraemia. Overzealous correction of hyponatraemia can be counterproductive.<\/jats:p>","DOI":"10.1136\/bcr-2016-218722","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T08:15:25Z","timestamp":1493194525000},"page":"bcr-2016-218722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Secondary parkinsonism in a patient of psychogenic polydipsia"],"prefix":"10.1136","volume":"2017","author":[{"given":"Rimesh","family":"Pal","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pinaki","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Bhansali","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,4,26]]},"reference":[{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1614.2001.00847.x"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-007-0025-7"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.3","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1959.02340140020004"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2013.04.005"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.jnen.0000196131.72302.68","article-title":"Central and extrapontine myelinolysis: then.and now","volume":"65","author":"Kleinschmidt-Demasters","year":"2006","journal-title":"J Neuropathol Exp Neurol"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.6","doi-asserted-by":"publisher","DOI":"10.1159\/000047939"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.7","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2005.031195"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.8","doi-asserted-by":"crossref","first-page":"181","DOI":"10.4103\/0028-3886.198197","article-title":"Newly described additional sites of extrapontine myelinolysis along with typical pontine and extrapontine myelinolysis","volume":"65","author":"Harsha","year":"2017","journal-title":"Neurol India"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.9","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.201764"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.10","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10331"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.11","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e3181d3cd78"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5486-7"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.13","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S1353-8020(02)00002-0","article-title":"Evolving spectrum of movement disorders in extrapontine and central pontine myelinolysis","volume":"9","author":"Seah","year":"2002","journal-title":"Parkinsonism Relat Disord"},{"key":"2025082706512944000_2017.apr26_1.bcr-2016-218722.14","first-page":"197","article-title":"Serum and urine sodium levels in dengue patients","volume":"36","author":"Mekmullica","year":"2005","journal-title":"Southeast Asian J Trop Med Public Health"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-218722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T13:51:36Z","timestamp":1756302696000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-218722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,26]]},"references-count":14,"alternative-id":["10.1136\/bcr-2016-218722"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-218722","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,26]]}}}