Secondary parkinsonism due to osmotic demyelination syndrome: a case report

Hyponatremia is a common medical problem often found in the elderly and is due to poor intake, medical comorbidities, and medications. Central to the management of this condition is the use of normal and hypertonic saline, besides the use of supplementary salt in diet and limited water intake. However, correction has to be slow; this depends upon whether the patient has acute or chronic hyponatremia. Rapid correction produces a myriad of clinical manifestations, commonly called as osmotic demyelination syndrome. The demyelination is pyramidal in most instances; the basis pontis is usually the frequent location. Extrapyramidal demyelination occurs in 10% of cases. Here, we present a form of extrapyramidal demyelination (i.e. secondary parkinsonism) secondary to osmotic demyelination syndrome, which has rarely been reported in the literature