{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:46:45Z","timestamp":1777312005550,"version":"3.51.4"},"reference-count":48,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Osmotic demyelination syndrome (ODS) is a rare but potentially life-threatening neurological disorder. It is characterized by non-inflammatory demyelination, usually triggered by sudden shifts in serum osmolality. However, emerging evidence suggests that abrupt osmotic shifts caused by severe hyperglycemia, even in the absence of sodium imbalance, can also precipitate ODS.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case presentation:<\/jats:bold>\n                    A 57-year-old male with poorly controlled type 2 diabetes mellitus and chronic alcohol use presented with recurrent seizures and altered sensorium. Initial blood work revealed severe hyperglycemia (390 mg\/dL), an elevated HbA1c level (15.2%), and a normal corrected serum sodium level (135 mEq\/L). During hospitalization, the patient developed progressive neurological deterioration, culminating in quadriplegia.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Imaging findings:<\/jats:bold>\n                    Initial non-contrast computed tomography (NCCT) of the brain was unremarkable. Magnetic resonance imaging (MRI) on day 11 showed symmetric T2\/FLAIR (Fluid-Attenuated\u00a0Inversion\u00a0Recovery) hyperintensities in the central pons extending into the middle cerebellar peduncles. These findings, in the absence of diffusion restriction or enhancement, were characteristic of central pontine myelinolysis (CPM). No extrapontine involvement was observed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Differential diagnosis:<\/jats:bold>\n                    Radiological differentials considered included acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), ischemic infarction, vasculitis, and brainstem glioma. However, the symmetric pontine involvement without enhancement or mass effect, along with the clinical context of hyperosmolar hyperglycemia, favored a diagnosis of ODS.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Management and outcome:<\/jats:bold>\n                    Supportive therapy involving careful glucose correction, intravenous hydration, and close monitoring of metabolic parameters was initiated. The patient showed gradual neurological recovery during the hospital course.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    This case highlights a rare presentation of CPM secondary to hyperosmolar hyperglycemia in the absence of hyponatremia. It underscores the importance of early recognition, neuroimaging, and cautious metabolic correction in diabetic patients presenting with new-onset neurological deficits.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2026.19","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:30:30Z","timestamp":1774895430000},"source":"Crossref","is-referenced-by-count":0,"title":["Neurological fallout of hyperglycemia: A case report of a rare presentation of osmotic demyelination syndrome"],"prefix":"10.5339","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4982-3983","authenticated-orcid":true,"given":"Rekha","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Radiodiagnosis & Imaging, Government Medical College and Hospital, Chandigarh, India*Correspondance: Chandrika Sachar chandrikasachar@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5135-5686","authenticated-orcid":true,"given":"Chandrika","family":"Sachar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis & Imaging, Government Medical College and Hospital, Chandigarh, India*Correspondance: Chandrika Sachar chandrikasachar@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6746-1565","authenticated-orcid":true,"given":"Parul","family":"Kaktyan","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis & Imaging, Government Medical College and Hospital, Chandigarh, India*Correspondance: Chandrika Sachar chandrikasachar@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"B1","series-title":"Dtsch Aerzteblatt Int","first-page":"600","article-title":"Central pontine myelinosis and osmotic demyelination syndrome","volume":"116","author":"Lambeck\n \nJ","year":"2019","unstructured":"Lambeck\n \nJ\n\n,\n\nHieber\n \nM\n\n,\n\nDre\u00dfing\n \nA\n\n,\n\nNiesen\n \nWD\n\n\n. \nCentral pontine myelinosis and osmotic demyelination syndrome\n. \nDtsch Aerzteblatt Int\n. \n2019\nSep 2\n116\n600\n6\n\nhttps:\/\/doi.org\/10.3238\/arztebl.2019.0600"},{"issue":"5","key":"B2","series-title":"Int J Mol Sci","article-title":"Osmotic demyelination: From an oligodendrocyte to an astrocyte perspective","volume":"20","author":"Nicaise\n \nC","year":"2019","unstructured":"Nicaise\n \nC\n\n,\n\nMarneffe\n \nC\n\n,\n\nBouchat\n \nJ\n\n,\n\nGilloteaux\n \nJ\n\n\n. \nOsmotic demyelination: From an oligodendrocyte to an astrocyte perspective\n. \nInt J Mol Sci\n. \n2019\nMar 5\n20\n5\n\nhttps:\/\/doi.org\/10.3390\/ijms20051124"},{"issue":"5","key":"B2-1","series-title":"Int J Mol Sci","first-page":"1124","article-title":"Osmotic demyelination: From an oligodendrocyte to an astrocyte perspective","volume":"20","author":"Nicaise\n \nC","year":"2019","unstructured":"Nicaise\n \nC\n\n,\n\nMarneffe\n \nC\n\n,\n\nBouchat\n \nJ\n\n,\n\nGilloteaux\n \nJ\n\n\n. \nOsmotic demyelination: From an oligodendrocyte to an astrocyte perspective\n. \nInt J Mol Sci\n. \n2019\nMar 5\n;\n20\n(\n5\n)\n:\n1124\n\nhttps:\/\/doi.org\/10.3390\/ijms20051124"},{"key":"B3","series-title":"SAGE Open Med Case Rep","article-title":"Occurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome","volume":"10","author":"Yadav\n \nSK","year":"2022","unstructured":"Yadav\n \nSK\n\n,\n\nOjha\n \nR\n\n,\n\nParajuli\n \nN\n\n,\n\nKarki\n \nS\n\n,\n\nPant\n \nS\n\n,\n\nKarn\n \nR\n\n\n\n. \nOccurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome\n. \nSAGE Open Med Case Rep\n. \n2022\nNov 1\n10\n\nhttps:\/\/doi.org\/10.1177\/2050313X221135595"},{"key":"B4","series-title":"Case Rep Neurol Med","article-title":"Central pontine and extrapontine myelinolysis: The great masquerader-an autopsy case report","volume":"2014","author":"Jacob\n \nS","year":"2014","unstructured":"Jacob\n \nS\n\n,\n\nGupta\n \nH\n\n,\n\nNikolic\n \nD\n\n,\n\nGundogdu\n \nB\n\n,\n\nOng\n \nS\n\n\n. \nCentral pontine and extrapontine myelinolysis: The great masquerader-an autopsy case report\n. \nCase Rep Neurol Med\n. \n2014\nMar 4\n2014\n\nhttps:\/\/doi.org\/10.1155\/2014\/745347"},{"issue":"2","key":"B5","series-title":"Neurocrit Care","first-page":"251","article-title":"Central pontine myelinolysis in a patient with hyperosmolar hyperglycemia and consistently normal serum sodium","volume":"11","author":"Burns\n \nJD","year":"2009","unstructured":"Burns\n \nJD\n\n,\n\nKosa\n \nSC\n\n,\n\nWijdicks\n \nEFM\n\n\n. \nCentral pontine myelinolysis in a patient with hyperosmolar hyperglycemia and consistently normal serum sodium\n. \nNeurocrit Care\n. \n2009\n11\n2\n251\n4\n\nhttps:\/\/doi.org\/10.1007\/s12028-009-9241-9"},{"key":"B6","series-title":"org\/10","article-title":"Osmotic demyelination syndrome in type 1 diabetes in the absence of dyselectrolytaemia: An overlooked complication? BMJ Case Rep","volume":"2017","author":"Sharma\n \nC","year":"2017","unstructured":"Sharma\n \nC\n\n,\n\nKumawat\n \nBL\n\n,\n\nPanchal\n \nM\n\n,\n\nShah\n \nM\n\n\n. \nOsmotic demyelination syndrome in type 1 diabetes in the absence of dyselectrolytaemia: An overlooked complication? BMJ Case Rep\n. \norg\/10\n. \n2017\nMay 12\n2017\n\nhttps:\/\/doi.org\/10.1136\/bcr-2016-219148"},{"issue":"3","key":"B7","series-title":"Am J Physiol Cell Physiol","article-title":"Hypertonic stress induces rapid and widespread protein damage in C","volume":"301","author":"Burkewitz\n \nK","year":"2011","unstructured":"Burkewitz\n \nK\n\n,\n\nChoe\n \nK\n\n,\n\nStrange\n \nK\n\n\n. \nHypertonic stress induces rapid and widespread protein damage in C\n. \nAm J Physiol Cell Physiol\n. \n2011\nSep\n301\n3\n\nhttps:\/\/doi.org\/10.1152\/ajpcell.00030.2011"},{"issue":"2","key":"B8","series-title":"AMA Arch Neurol Psychiatry","first-page":"154","article-title":"Central pontine myelinolysis: A hitherto undescribed disease occurring in alcoholic and malnourished patients","volume":"81","author":"Adams\n \nRD","year":"1959","unstructured":"Adams\n \nRD\n\n,\n\nVictor\n \nM\n\n,\n\nMancall\n \nEL\n\n\n. \nCentral pontine myelinolysis: A hitherto undescribed disease occurring in alcoholic and malnourished patients\n. \nAMA Arch Neurol Psychiatry\n. \n1959\nFeb\n81\n2\n154\n72\n\nhttps:\/\/doi.org\/10.1001\/archneurpsyc.1959.02340140020004"},{"issue":"12","key":"B9","series-title":"Eur J Neurol","first-page":"1443","article-title":"Central pontine and extrapontine myelinolysis: A systematic review","volume":"21","author":"Singh\n \nTD","year":"2014","unstructured":"Singh\n \nTD\n\n,\n\nFugate\n \nJE\n\n,\n\nRabinstein\n \nAA\n\n\n. \nCentral pontine and extrapontine myelinolysis: A systematic review\n. \nEur J Neurol\n. \n2014\nDec\n21\n12\n1443\n50\n\nhttps:\/\/doi.org\/10.1111\/ene.12571"},{"issue":"4","key":"B10","series-title":"Transl Biomed","first-page":"1","article-title":"Current concepts in pontine myelinolysis: Review of literature","volume":"6","author":"Dagur\n \nG","year":"2015","unstructured":"Dagur\n \nG\n\n,\n\nKhan\n \nSA\n\n\n. \nCurrent concepts in pontine myelinolysis: Review of literature\n. \nTransl Biomed\n. \n2015\n6\n4\n1\n7\n\nhttps:\/\/doi.org\/10.21767\/2172-0479.100038"},{"key":"B11","series-title":"11. Graham DI, Lantos PL, editors. Greenfield\u2018s neuropathology.\u00a07th ed. London, UK: Arnold\/Oxford University Press; 2002.","article-title":"Greenfield\u2018s neuropathology","author":"Graham\n \nDI","year":"2002","unstructured":"Graham\n \nDI\n\n,\n\nLantos\n \nPL\n\n\neditors\n. \nGreenfield\u2018s neuropathology\n. \n11. Graham DI, Lantos PL, editors. Greenfield\u2018s neuropathology.\u00a07th ed. London, UK: Arnold\/Oxford University Press; 2002.\n. \n2002"},{"issue":"7","key":"B12","series-title":"N Engl J Med","article-title":"Central pontine myelinolysis","volume":"374","author":"Tavare\n \nAN","year":"2016","unstructured":"Tavare\n \nAN\n\n,\n\nMurray\n \nD\n\n\n. \nCentral pontine myelinolysis\n. \nN Engl J Med\n. \n2016\nFeb 18\n374\n7\n\nhttps:\/\/doi.org\/10.1056\/NEJMicm1504134"},{"issue":"6","key":"B13","first-page":"326","article-title":"Is central pontine myelinolysis reversible? Wis Med J","volume":"115","author":"Rebedew\n \nDL","year":"2016","unstructured":"Rebedew\n \nDL\n\n\n. \nIs central pontine myelinolysis reversible? Wis Med J\n. \n2016\nDec\n115\n6\n326\n8\nAvailable from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29095576\n."},{"issue":"6","key":"B14","series-title":"J Clin Neurosci","first-page":"894","article-title":"Hemiparesis, encephalopathy, and extrapontine osmotic myelinolysis in the setting of hyperosmolar hyperglycemia","volume":"20","author":"Guerrero\n \nWR","year":"2013","unstructured":"Guerrero\n \nWR\n\n,\n\nDababneh\n \nH\n\n,\n\nNadeau\n \nSE\n\n\n. \nHemiparesis, encephalopathy, and extrapontine osmotic myelinolysis in the setting of hyperosmolar hyperglycemia\n. \nJ Clin Neurosci\n. \n2013\nJun\n20\n6\n894\n6\n\nhttps:\/\/doi.org\/10.1016\/j.jocn.2012.05.045"},{"key":"B15","series-title":"Rev Neurol (Paris)","first-page":"66","article-title":"Central pontine myelinolysis in a type 1 diabetes patient with chronic hepatitis","volume":"174","author":"Gourine\n \nM","year":"2018","unstructured":"Gourine\n \nM\n\n,\n\nMostefa-Kara\n \nA\n\n,\n\nSaadi\n \nS\n\n,\n\nArrar\n \nM\n\n,\n\n\u00a0 Cherrak\n \nA\n\n\n. \nCentral pontine myelinolysis in a type 1 diabetes patient with chronic hepatitis\n. \nRev Neurol (Paris)\n. \n2018\nJan\n174\n66\n7\n\nhttps:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Arrar+M&cauthor_id=28583270"},{"issue":"6","key":"B16","series-title":"Eur J Paediatr Neurol","first-page":"389","article-title":"Extrapontine myelinolysis in a 4-year-old with diabetic ketoacidosis","volume":"11","author":"Sivaswamy\n \nL","year":"2007","unstructured":"Sivaswamy\n \nL\n\n,\n\nKaria\n \nS\n\n\n. \nExtrapontine myelinolysis in a 4-year-old with diabetic ketoacidosis\n. \nEur J Paediatr Neurol\n. \n2007\nNov\n11\n6\n389\n93\n\nhttps:\/\/doi.org\/10.1016\/j.ejpn.2007.02.017"},{"key":"B17","series-title":"Front Neurol","article-title":"Central pontine myelinolysis: A rare finding in hyperosmolar hyperglycemia","volume":"14","author":"Qu\n \nHL","year":"2023","unstructured":"Qu\n \nHL\n\n,\n\nSun\n \nXY\n\n,\n\nDai\n \nYJ\n\n\n. \nCentral pontine myelinolysis: A rare finding in hyperosmolar hyperglycemia\n. \nFront Neurol\n. \n2023\nOct 24\n14\n\nhttps:\/\/doi.org\/10.3389\/fneur.2023.1216328"},{"issue":"3","key":"B18","series-title":"\u00a0Indian J Endocrinol Metab","first-page":"434","article-title":"Pontine myelinolysis as the presenting complication of Type 2 diabetes mellitus","volume":"22","author":"Ramineni\n \nKK","year":"2018","unstructured":"Ramineni\n \nKK\n\n,\n\nReddy\n \nKM\n\n,\n\nPrusthi\n \nBSK\n\n,\n\nJakkani\n \nRK\n\n\n. \nPontine myelinolysis as the presenting complication of Type 2 diabetes mellitus\n. \n\u00a0Indian J Endocrinol Metab\n. \n2018\nMay\n22\n3\n434\n5"},{"issue":"12","key":"B19","series-title":"Radiol Case Rep","first-page":"4318","article-title":"Insights from neuroradiology in acute disseminated encephalomyelitis","volume":"18","author":"Khatri\n \nS","year":"2023","unstructured":"Khatri\n \nS\n\n,\n\nXerras\n \nM\n\n,\n\nChamay\n \nS\n\n,\n\nSharma\n \nS\n\n\n. \nInsights from neuroradiology in acute disseminated encephalomyelitis\n. \nRadiol Case Rep\n. \n2023\nSep 26\n18\n12\n4318\n22\n\nhttps:\/\/doi.org\/10.1016\/j.radcr.2023.09.020"},{"issue":"3","key":"B20","series-title":"Lancet Neurol","first-page":"292","article-title":"MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines","volume":"15","author":"Filippi\n \nM","year":"2016","unstructured":"Filippi\n \nM\n\n,\n\nRocca\n \nMA\n\n,\n\nCiccarelli\n \nO\n\n,\n\nDe Stefano\n \nN\n\n,\n\nEvangelou\n \nN\n\n,\n\nKappos\n \nL\n\n\n\n. \nMRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines\n. \nLancet Neurol\n. \n2016\nMar\n15\n3\n292\n303\n\nhttps:\/\/doi.org\/10.1016\/S1474-4422(15)00393-2"},{"key":"B21","series-title":"AJR Am J Roentgenol","article-title":"AJR teaching file: Symmetric demyelination","volume":"191","author":"Venkatanarasimha\n \nN","year":"2008","unstructured":"Venkatanarasimha\n \nN\n\n,\n\nMukonoweshuro\n \nW\n\n,\n\nJones\n \nJ\n\n\n. \nAJR teaching file: Symmetric demyelination\n. \nAJR Am J Roentgenol\n. \n2008\nSep\n191\n\nhttps:\/\/doi.org\/10.2214\/AJR.07.7052"},{"issue":"3","key":"B22","first-page":"149","article-title":"Therapeutic recommendations for management of severe hyponatremia: Current concepts on pathogenesis and prevention of neurologic complications","volume":"46","author":"Soupart\n \nA","year":"1996","unstructured":"Soupart\n \nA\n\n,\n\nDecaux\n \nG\n\n\n. \nTherapeutic recommendations for management of severe hyponatremia: Current concepts on pathogenesis and prevention of neurologic complications\n. \n1996\nSep\n46\n3\n149\n69\nAvailable from: https:\/\/pubmed.ncbi.nlm.nih.gov\/8879850\n."},{"issue":"6","key":"B23","series-title":"Alcohol Alcohol","first-page":"647","article-title":"Central pontine and extrapontine myelinolysis after alcohol withdrawal","volume":"43","author":"Yoon\n \nB","year":"2008","unstructured":"Yoon\n \nB\n\n,\n\nShim\n \nYS\n\n,\n\nChung\n \nSW\n\n\n. \nCentral pontine and extrapontine myelinolysis after alcohol withdrawal\n. \nAlcohol Alcohol\n. \n2008\nNov\n43\n6\n647\n9\n\nhttps:\/\/doi.org\/10.1093\/alcalc\/agn050"},{"key":"B1","series-title":"Dtsch Aerzteblatt Int","first-page":"600","article-title":"Central pontine myelinosis and osmotic demyelination syndrome","volume":"116","author":"Lambeck\n \nJ","year":"2019","unstructured":"Lambeck\n \nJ\n\n,\n\nHieber\n \nM\n\n,\n\nDre\u00dfing\n \nA\n\n,\n\nNiesen\n \nWD\n\n\n. \nCentral pontine myelinosis and osmotic demyelination syndrome\n. \nDtsch Aerzteblatt Int\n. \n2019\nSep 2\n116\n600\n6\n\nhttps:\/\/doi.org\/10.3238\/arztebl.2019.0600"},{"issue":"5","key":"B2","series-title":"Int J Mol Sci","article-title":"Osmotic demyelination: From an oligodendrocyte to an astrocyte perspective","volume":"20","author":"Nicaise\n \nC","year":"2019","unstructured":"Nicaise\n \nC\n\n,\n\nMarneffe\n \nC\n\n,\n\nBouchat\n \nJ\n\n,\n\nGilloteaux\n \nJ\n\n\n. \nOsmotic demyelination: From an oligodendrocyte to an astrocyte perspective\n. \nInt J Mol Sci\n. \n2019\nMar 5\n20\n5\n\nhttps:\/\/doi.org\/10.3390\/ijms20051124"},{"issue":"5","key":"B2-1","series-title":"Int J Mol Sci","first-page":"1124","article-title":"Osmotic demyelination: From an oligodendrocyte to an astrocyte perspective","volume":"20","author":"Nicaise\n \nC","year":"2019","unstructured":"Nicaise\n \nC\n\n,\n\nMarneffe\n \nC\n\n,\n\nBouchat\n \nJ\n\n,\n\nGilloteaux\n \nJ\n\n\n. \nOsmotic demyelination: From an oligodendrocyte to an astrocyte perspective\n. \nInt J Mol Sci\n. \n2019\nMar 5\n;\n20\n(\n5\n)\n:\n1124\n\nhttps:\/\/doi.org\/10.3390\/ijms20051124"},{"key":"B3","series-title":"SAGE Open Med Case Rep","article-title":"Occurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome","volume":"10","author":"Yadav\n \nSK","year":"2022","unstructured":"Yadav\n \nSK\n\n,\n\nOjha\n \nR\n\n,\n\nParajuli\n \nN\n\n,\n\nKarki\n \nS\n\n,\n\nPant\n \nS\n\n,\n\nKarn\n \nR\n\n\n\n. \nOccurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome\n. \nSAGE Open Med Case Rep\n. \n2022\nNov 1\n10\n\nhttps:\/\/doi.org\/10.1177\/2050313X221135595"},{"key":"B4","series-title":"Case Rep Neurol Med","article-title":"Central pontine and extrapontine myelinolysis: The great masquerader-an autopsy case report","volume":"2014","author":"Jacob\n \nS","year":"2014","unstructured":"Jacob\n \nS\n\n,\n\nGupta\n \nH\n\n,\n\nNikolic\n \nD\n\n,\n\nGundogdu\n \nB\n\n,\n\nOng\n \nS\n\n\n. \nCentral pontine and extrapontine myelinolysis: The great masquerader-an autopsy case report\n. \nCase Rep Neurol Med\n. \n2014\nMar 4\n2014\n\nhttps:\/\/doi.org\/10.1155\/2014\/745347"},{"issue":"2","key":"B5","series-title":"Neurocrit Care","first-page":"251","article-title":"Central pontine myelinolysis in a patient with hyperosmolar hyperglycemia and consistently normal serum sodium","volume":"11","author":"Burns\n \nJD","year":"2009","unstructured":"Burns\n \nJD\n\n,\n\nKosa\n \nSC\n\n,\n\nWijdicks\n \nEFM\n\n\n. \nCentral pontine myelinolysis in a patient with hyperosmolar hyperglycemia and consistently normal serum sodium\n. \nNeurocrit Care\n. \n2009\n11\n2\n251\n4\n\nhttps:\/\/doi.org\/10.1007\/s12028-009-9241-9"},{"key":"B6","series-title":"org\/10","article-title":"Osmotic demyelination syndrome in type 1 diabetes in the absence of dyselectrolytaemia: An overlooked complication? BMJ Case Rep","volume":"2017","author":"Sharma\n \nC","year":"2017","unstructured":"Sharma\n \nC\n\n,\n\nKumawat\n \nBL\n\n,\n\nPanchal\n \nM\n\n,\n\nShah\n \nM\n\n\n. \nOsmotic demyelination syndrome in type 1 diabetes in the absence of dyselectrolytaemia: An overlooked complication? BMJ Case Rep\n. \norg\/10\n. \n2017\nMay 12\n2017\n\nhttps:\/\/doi.org\/10.1136\/bcr-2016-219148"},{"issue":"3","key":"B7","series-title":"Am J Physiol Cell Physiol","article-title":"Hypertonic stress induces rapid and widespread protein damage in C","volume":"301","author":"Burkewitz\n \nK","year":"2011","unstructured":"Burkewitz\n \nK\n\n,\n\nChoe\n \nK\n\n,\n\nStrange\n \nK\n\n\n. \nHypertonic stress induces rapid and widespread protein damage in C\n. \nAm J Physiol Cell Physiol\n. \n2011\nSep\n301\n3\n\nhttps:\/\/doi.org\/10.1152\/ajpcell.00030.2011"},{"issue":"2","key":"B8","series-title":"AMA Arch Neurol Psychiatry","first-page":"154","article-title":"Central pontine myelinolysis: A hitherto undescribed disease occurring in alcoholic and malnourished patients","volume":"81","author":"Adams\n \nRD","year":"1959","unstructured":"Adams\n \nRD\n\n,\n\nVictor\n \nM\n\n,\n\nMancall\n \nEL\n\n\n. \nCentral pontine myelinolysis: A hitherto undescribed disease occurring in alcoholic and malnourished patients\n. \nAMA Arch Neurol Psychiatry\n. \n1959\nFeb\n81\n2\n154\n72\n\nhttps:\/\/doi.org\/10.1001\/archneurpsyc.1959.02340140020004"},{"issue":"12","key":"B9","series-title":"Eur J Neurol","first-page":"1443","article-title":"Central pontine and extrapontine myelinolysis: A systematic review","volume":"21","author":"Singh\n \nTD","year":"2014","unstructured":"Singh\n \nTD\n\n,\n\nFugate\n \nJE\n\n,\n\nRabinstein\n \nAA\n\n\n. \nCentral pontine and extrapontine myelinolysis: A systematic review\n. \nEur J Neurol\n. \n2014\nDec\n21\n12\n1443\n50\n\nhttps:\/\/doi.org\/10.1111\/ene.12571"},{"issue":"4","key":"B10","series-title":"Transl Biomed","first-page":"1","article-title":"Current concepts in pontine myelinolysis: Review of literature","volume":"6","author":"Dagur\n \nG","year":"2015","unstructured":"Dagur\n \nG\n\n,\n\nKhan\n \nSA\n\n\n. \nCurrent concepts in pontine myelinolysis: Review of literature\n. \nTransl Biomed\n. \n2015\n6\n4\n1\n7\n\nhttps:\/\/doi.org\/10.21767\/2172-0479.100038"},{"key":"B11","series-title":"11. Graham DI, Lantos PL, editors. Greenfield\u2018s neuropathology.\u00a07th ed. London, UK: Arnold\/Oxford University Press; 2002.","article-title":"Greenfield\u2018s neuropathology","author":"Graham\n \nDI","year":"2002","unstructured":"Graham\n \nDI\n\n,\n\nLantos\n \nPL\n\n\neditors\n. \nGreenfield\u2018s neuropathology\n. \n11. Graham DI, Lantos PL, editors. Greenfield\u2018s neuropathology.\u00a07th ed. London, UK: Arnold\/Oxford University Press; 2002.\n. \n2002"},{"issue":"7","key":"B12","series-title":"N Engl J Med","article-title":"Central pontine myelinolysis","volume":"374","author":"Tavare\n \nAN","year":"2016","unstructured":"Tavare\n \nAN\n\n,\n\nMurray\n \nD\n\n\n. \nCentral pontine myelinolysis\n. \nN Engl J Med\n. \n2016\nFeb 18\n374\n7\n\nhttps:\/\/doi.org\/10.1056\/NEJMicm1504134"},{"issue":"6","key":"B13","first-page":"326","article-title":"Is central pontine myelinolysis reversible? Wis Med J","volume":"115","author":"Rebedew\n \nDL","year":"2016","unstructured":"Rebedew\n \nDL\n\n\n. \nIs central pontine myelinolysis reversible? Wis Med J\n. \n2016\nDec\n115\n6\n326\n8\nAvailable from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29095576\n."},{"issue":"6","key":"B14","series-title":"J Clin Neurosci","first-page":"894","article-title":"Hemiparesis, encephalopathy, and extrapontine osmotic myelinolysis in the setting of hyperosmolar hyperglycemia","volume":"20","author":"Guerrero\n \nWR","year":"2013","unstructured":"Guerrero\n \nWR\n\n,\n\nDababneh\n \nH\n\n,\n\nNadeau\n \nSE\n\n\n. \nHemiparesis, encephalopathy, and extrapontine osmotic myelinolysis in the setting of hyperosmolar hyperglycemia\n. \nJ Clin Neurosci\n. \n2013\nJun\n20\n6\n894\n6\n\nhttps:\/\/doi.org\/10.1016\/j.jocn.2012.05.045"},{"key":"B15","series-title":"Rev Neurol (Paris)","first-page":"66","article-title":"Central pontine myelinolysis in a type 1 diabetes patient with chronic hepatitis","volume":"174","author":"Gourine\n \nM","year":"2018","unstructured":"Gourine\n \nM\n\n,\n\nMostefa-Kara\n \nA\n\n,\n\nSaadi\n \nS\n\n,\n\nArrar\n \nM\n\n,\n\n\u00a0 Cherrak\n \nA\n\n\n. \nCentral pontine myelinolysis in a type 1 diabetes patient with chronic hepatitis\n. \nRev Neurol (Paris)\n. \n2018\nJan\n174\n66\n7\n\nhttps:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Arrar+M&cauthor_id=28583270"},{"issue":"6","key":"B16","series-title":"Eur J Paediatr Neurol","first-page":"389","article-title":"Extrapontine myelinolysis in a 4-year-old with diabetic ketoacidosis","volume":"11","author":"Sivaswamy\n \nL","year":"2007","unstructured":"Sivaswamy\n \nL\n\n,\n\nKaria\n \nS\n\n\n. \nExtrapontine myelinolysis in a 4-year-old with diabetic ketoacidosis\n. \nEur J Paediatr Neurol\n. \n2007\nNov\n11\n6\n389\n93\n\nhttps:\/\/doi.org\/10.1016\/j.ejpn.2007.02.017"},{"key":"B17","series-title":"Front Neurol","article-title":"Central pontine myelinolysis: A rare finding in hyperosmolar hyperglycemia","volume":"14","author":"Qu\n \nHL","year":"2023","unstructured":"Qu\n \nHL\n\n,\n\nSun\n \nXY\n\n,\n\nDai\n \nYJ\n\n\n. \nCentral pontine myelinolysis: A rare finding in hyperosmolar hyperglycemia\n. \nFront Neurol\n. \n2023\nOct 24\n14\n\nhttps:\/\/doi.org\/10.3389\/fneur.2023.1216328"},{"issue":"3","key":"B18","series-title":"\u00a0Indian J Endocrinol Metab","first-page":"434","article-title":"Pontine myelinolysis as the presenting complication of Type 2 diabetes mellitus","volume":"22","author":"Ramineni\n \nKK","year":"2018","unstructured":"Ramineni\n \nKK\n\n,\n\nReddy\n \nKM\n\n,\n\nPrusthi\n \nBSK\n\n,\n\nJakkani\n \nRK\n\n\n. \nPontine myelinolysis as the presenting complication of Type 2 diabetes mellitus\n. \n\u00a0Indian J Endocrinol Metab\n. \n2018\nMay\n22\n3\n434\n5"},{"issue":"12","key":"B19","series-title":"Radiol Case Rep","first-page":"4318","article-title":"Insights from neuroradiology in acute disseminated encephalomyelitis","volume":"18","author":"Khatri\n \nS","year":"2023","unstructured":"Khatri\n \nS\n\n,\n\nXerras\n \nM\n\n,\n\nChamay\n \nS\n\n,\n\nSharma\n \nS\n\n\n. \nInsights from neuroradiology in acute disseminated encephalomyelitis\n. \nRadiol Case Rep\n. \n2023\nSep 26\n18\n12\n4318\n22\n\nhttps:\/\/doi.org\/10.1016\/j.radcr.2023.09.020"},{"issue":"3","key":"B20","series-title":"Lancet Neurol","first-page":"292","article-title":"MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines","volume":"15","author":"Filippi\n \nM","year":"2016","unstructured":"Filippi\n \nM\n\n,\n\nRocca\n \nMA\n\n,\n\nCiccarelli\n \nO\n\n,\n\nDe Stefano\n \nN\n\n,\n\nEvangelou\n \nN\n\n,\n\nKappos\n \nL\n\n\n\n. \nMRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines\n. \nLancet Neurol\n. \n2016\nMar\n15\n3\n292\n303\n\nhttps:\/\/doi.org\/10.1016\/S1474-4422(15)00393-2"},{"key":"B21","series-title":"AJR Am J Roentgenol","article-title":"AJR teaching file: Symmetric demyelination","volume":"191","author":"Venkatanarasimha\n \nN","year":"2008","unstructured":"Venkatanarasimha\n \nN\n\n,\n\nMukonoweshuro\n \nW\n\n,\n\nJones\n \nJ\n\n\n. \nAJR teaching file: Symmetric demyelination\n. \nAJR Am J Roentgenol\n. \n2008\nSep\n191\n\nhttps:\/\/doi.org\/10.2214\/AJR.07.7052"},{"issue":"3","key":"B22","first-page":"149","article-title":"Therapeutic recommendations for management of severe hyponatremia: Current concepts on pathogenesis and prevention of neurologic complications","volume":"46","author":"Soupart\n \nA","year":"1996","unstructured":"Soupart\n \nA\n\n,\n\nDecaux\n \nG\n\n\n. \nTherapeutic recommendations for management of severe hyponatremia: Current concepts on pathogenesis and prevention of neurologic complications\n. \n1996\nSep\n46\n3\n149\n69\nAvailable from: https:\/\/pubmed.ncbi.nlm.nih.gov\/8879850\n."},{"issue":"6","key":"B23","series-title":"Alcohol Alcohol","first-page":"647","article-title":"Central pontine and extrapontine myelinolysis after alcohol withdrawal","volume":"43","author":"Yoon\n \nB","year":"2008","unstructured":"Yoon\n \nB\n\n,\n\nShim\n \nYS\n\n,\n\nChung\n \nSW\n\n\n. \nCentral pontine and extrapontine myelinolysis after alcohol withdrawal\n. \nAlcohol Alcohol\n. \n2008\nNov\n43\n6\n647\n9\n\nhttps:\/\/doi.org\/10.1093\/alcalc\/agn050"}],"container-title":["Qatar Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2026\/1\/article-19.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2026\/1\/article-19.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2026\/1\/article-19.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:10:01Z","timestamp":1777309801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2026\/1\/article-19.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":48,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.5339\/qmj.2026.19","relation":{},"ISSN":["2227-0426"],"issn-type":[{"value":"2227-0426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}