Abstract
RATIONALE: Osmotic demyelination syndrome (ODS) is a noninflammatory demyelinating disorder involving the pontis and other regions of the central nervous system. This article tries to enhance the understanding of ODS. Combined with clinical features, we use laboratory/imaging examination and literature review. PATIENT CONCERNS: We report on 4 ODS cases and review the different etiologies, clinical manifestations, and possible pathophysiology. DIAGNOSES: We provide an update on the diagnosis and treatment of ODS, with a special focus on the prevention of ODS. INTERVENTIONS: We corrected the hyponatremia appropriately and treated complications. OUTCOMES: The development of ODS is by association with a variety of clinical conditions. Also, the prognosis of ODS is heterogeneous, ranging from complete recovery to vegetative state, even death. However, there is no specific effective treatment, thus, it is more important to recognize the path mechanism of ODS and to avoid its occurrence. LESSONS: It is essential to reduce the risk of suffering this potentially devastating disease through an appropriate rate of hyponatremia correction and the treatment of comorbid clinical conditions.