The response of osmotic demyelination syndrome to plasmapheresis in a patient presenting with catatonia after correction of hyponatraemia in hyperemesis gravidarum
  • Vimonsri Rangsrisaeneepitak
    Division of Endocrinology and Metabolism, Department of Medicine, Burapha University, Chonburi, Thailand
  • Arnant Tekarnjnavanit
    Department of Medicine, Burapha University, Chonburi, Thailand
  • Pattarapol Kanjanapipatkul
    Division of Neurology, Department of Medicine, Burapha University, Chonburi, Thailand
  • Sukrisd Koowattanatianchai
    Division of Cardiology, Department of Medicine, Burapha University, Chonburi, Thailand


Osmotic demyelination syndrome, catatonia, hyponatraemia, hyperemesis gravidarum, plasmapheresis


Osmotic demyelination syndrome (ODS) is a disorder characterised by the widespread development of demyelination in both pontine and extrapontine regions. It has been recognised as a complication arising from the rapid correction of hyponatraemia. This study presents the case of a 20-year-old Thai female patient at 10 weeks gestation, exhibiting an initial presentation of catatonia – an uncommon manifestation of ODS. The patient developed symptoms following the rapid correction of hyponatraemia in the context of hyperemesis gravidarum. Magnetic resonance imaging (MRI) of the brain revealed a trident or bat-wing-shaped pattern in T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences at the central pons. The patient underwent five cycles of plasmapheresis and received rehabilitation, leading to clinical improvement.



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    Published: 2024-03-11
    Issue: 2024: Vol 11 No 4 (view)

    How to cite:
    Rangsrisaeneepitak V, Tekarnjnavanit A, Kanjanapipatkul P, Koowattanatianchai S. The response of osmotic demyelination syndrome to plasmapheresis in a patient presenting with catatonia after correction of hyponatraemia in hyperemesis gravidarum. EJCRIM 2024;11 doi:10.12890/2024_004373.

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