Journal of NeuroVirology

, Volume 22, Issue 6, pp 876–879

Normonatremic osmotic demyelination in the setting of acquired immune deficiency syndrome and malnutrition: case report and literature review

  • James E. Siegler
  • Amber R. Wang
  • Joshua D. Vanderwerf
Case Report

DOI: 10.1007/s13365-016-0463-2

Cite this article as:
Siegler, J.E., Wang, A.R. & Vanderwerf, J.D. J. Neurovirol. (2016) 22: 876. doi:10.1007/s13365-016-0463-2


In this report, we present the case of a 43-year-old woman with AIDS, disseminated aspergillosis, and malnutrition who developed osmotic demyelination syndrome. AIDS-related osmotic demyelination has only been documented in a handful of cases to date, and it appears independent of the classic mechanism of rapid correction of hyponatremia. In this manuscript, we review the six prior cases of osmotic demyelination in AIDS patients and compare their circumstances to that of our own patient. It appears that complications of malnutrition, possibly related to depletion of organic osmolytes in the central nervous system, may place AIDS patients at greater risk of osmotic demyelination. These, and other proposed mechanisms, deserve further inquiry.


Osmotic demyelination Posterior reversible encephalopathy Acquired immune deficiency syndrome Aspergillosis Status epilepticus 

Supplementary material

13365_2016_463_MOESM1_ESM.png (111 kb)
Supplementary Figure 1Serum laboratory results in the 7 days preceding and 3 days following MRI diagnosis of osmotic demyelination. Serum osmolality was not assessed. MRI denotes magnetic resonance imaging, HD hospital day. (PNG 111 kb)

Copyright information

© Journal of NeuroVirology, Inc. 2016

Authors and Affiliations

  • James E. Siegler
    • 1
  • Amber R. Wang
    • 2
  • Joshua D. Vanderwerf
    • 1
  1. 1.Department of NeurologyHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaUSA

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