Cortical MRI findings associated with rapid correction of hyponatremia

The authors describe two patients with clinical manifestations of the osmot ic demyelination syndrome (ODS) and unusual MRI findings of gadolinium-enha ncing peripheral cortical abnormalities. They propose that these represent extrapontine manifestations of ODS because neither patient had a notable hy poxic-ischemic insult. Recognizing this imaging appearance is important bec ause prognosis in ODS may be less uniformly grim than for hypoxia-ischemia.