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She was treated for hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone (SIADH) and urosepsis. However, her serum sodium failed to normalise despite fluid restriction, necessitating treatment with demeclocycline and hypertonic saline. Despite slow reversal of hyponatraemia over 1 month, the patient developed generalised seizures with pontine and thalamic changes on MRI consistent with osmotic demyelination syndrome (ODS). This case highlights the risk of ODS, a rare but devastating consequence of hyponatraemia treatment, despite cautious sodium correction.<\/jats:p>","DOI":"10.1136\/bcr-2020-241407","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T12:51:53Z","timestamp":1628513513000},"page":"e241407","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Osmotic demyelination syndrome following slow correction of hyponatraemia"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7118-3025","authenticated-orcid":false,"given":"Isabel","family":"Saunders","sequence":"first","affiliation":[{"name":"Diabetes and Endocrinology, Singleton Hospital, Swansea, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9206-5837","authenticated-orcid":false,"given":"David M","family":"Williams","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Singleton Hospital, Swansea, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya Mohd","family":"Ruslan","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Singleton Hospital, Swansea, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thinzar","family":"Min","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, Singleton Hospital, Swansea, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"key":"2025082803111915000_14.8.e241407.1","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2015-133740"},{"key":"2025082803111915000_14.8.e241407.2","doi-asserted-by":"publisher","DOI":"10.1530\/EC-16-0046"},{"key":"2025082803111915000_14.8.e241407.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1995.tb06623.x"},{"key":"2025082803111915000_14.8.e241407.4","first-page":"108","article-title":"[Serum sodium concentration profile for cirrhotic patients and its effect on the prognostic value of the MELD score]","volume":"20","author":"Zhang","year":"2012","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"2025082803111915000_14.8.e241407.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3210-2"},{"key":"2025082803111915000_14.8.e241407.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-020-02573-9","article-title":"Effective treatment of osmotic demyelination syndrome with plasmapheresis: a case report and review of the literature","volume":"15","author":"Wijayabandara","year":"2021","journal-title":"J Med Case Rep"},{"key":"2025082803111915000_14.8.e241407.7","unstructured":"EMC . 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