Osmotic Demyelination Syndrome in Anorexia Nervosa: Serial MRI Findings After Rapid Sodium Correction

Rapid correction of severe hyponatremia (23.2 mmol/L/24h) in a woman with binge-eating/purging anorexia nervosa led to osmotic demyelination syndrome. Serial brain MRI showed central pontine and extrapontine myelinolysis. Radiologists should recognize ODS in patients with eating…

• Serum sodium rose from 103.52 to 123.34 mmol/L over ~20.5 hours, a rate of 23.2 mmol/L/day, well above safe limits.
• Serial MRI demonstrated both central pontine myelinolysis and extrapontine myelinolysis involving the pons, basal ganglia, and cerebellum.
• The patient showed substantial functional recovery at 7-month follow-up (FIM score 126) after corticosteroid therapy and multidisciplinary rehabilitation.

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