Hey, I've read a few of your replies on this thread and wanted to give a (not official advice) medical perspective. I can't imagine what you and your wife are g

Hey, I've read a few of your replies on this thread and wanted to give a (not official advice) medical perspective. I can't imagine what you and your wife are going through at the moment. As someone working in Australia, the US healthcare system sounds even worse than the stories. Firstly, her sodium was initially pretty drastically low for just diarrhoea - almost to the point of seizures - unless she was permanently on the toilet and vomiting, and guzzling water (without electrolytes) - suggesting there may be some other underlying cause worth looking into, if she doesn't have major organ failure normally - heart, liver, kidneys. Secondly, it was absolutely replaced too quickly - though osmotic demyelination syndrome is typically in chronic hyponatraemics whereas if your wife is normally healthy, her sodium should be in the normal range and an acute diarrhoeal illness, whilst a unlikely but possible cause of severe hyponatraemia, would generally be a more acute process. The pathophysiology is essentially that your brain adapts to low sodium and then when electrolytes are replaced rapidly, the brain shrinks rapidly which causes damage to the cells. Thirdly, benzodiazepine withdrawal is absolutely not pleasant and could definitely contribute/worsen symptoms so that sounds like a terrible idea stopping without a taper. Personally, I have never seen ODS/myelinolysis but a normal MRI is reassuring and it technically means the diagnosis is no longer possible - there are cases where early MRIs haven't demonstrated any changes but the evidence states that typically by 4 weeks if there is any damage, a scan should show it. Obviously I don't know what other investigations have been done already, but I hope you and your wife reach a satisfactory resolution, even if it doesn't result in a definite diagnosis - unfortunately there are still many aspects of human health that we don't know about and definitely things exist that we cannot explain. For example, some aspects of the story that you've described make me think of fibromyalgia, which we don't have any good clinical diagnostic test for at this stage - it's just a clinical diagnosis. I'm not saying to give up, but sometimes chasing a definitive diagnosis often ends up proving futile and worsening the whole prognosis - just think about what you and your wife's goals are. Also, on a sidenote, restless legs syndrome is a real condition (I'm not saying she has it but yes, it is real).