Pediatric osmotic demyelination syndrome triggered by post-traumatic pituitary stalk injury: a case report

Osmotic demyelination syndrome (ODS) is an acute neurological disorder resulting from demyelination, typically triggered by rapid osmotic shifts. This syndrome is rare in adults and even more uncommon in children.To date, no reported cases have documented ODS secondary to hyponatremia caused by post-traumatic pituitary stalk injury. We report a pediatric patient with traumatic brain injury who developed ODS subsequent to pituitary stalk disruption and hyponatremia, and discuss the corresponding diagnostic and therapeutic strategies.

We report the case of a 13-year-old Chinese girl who presented with seizures, central diabetes insipidus, dysarthria, dysphagia, and painful hypertonia following traumatic brain injury. Laboratory investigation revealed Severe hyponatremia. Magnetic resonance imaging (MRI)confirmed the diagnosis of ODS. The child was managed accordingly and demonstrated a favorable clinical response, with substantial recovery in physical function and quality of life.

Early diagnosis of ODS is based on recognizing key risk factors, typical clinical symptoms, and characteristic neuroimaging findings. Contrast-enhanced MRI can be critical in elucidating the underlying etiology. B-complex vitamins and hyperbaric oxygen therapy have the potential to improve disease outcomes.