Secondary demyelinating entity
Happens with rapid correction of hyponatremia, usually iatrogenic, and usually in alcoholics, the debilitated or malnourished. Also associated with renal failure, liver disease, diabetes, disequilibrium syndrome, inappropriate antidiuetic hormone secretion.
In peds, has been associated with orthotopic liver transplant, AML, Hodgkin's, Wilson, craniopharyngioma.
Patient deteriorates subacutely after the correction progressing to coma, quadriparesis, pseudobulbar palsy, extrapyramidal symptoms.