Neurological counterparts of hyponatremia: pathological mechanisms and clinical manifestations.

Abstract

Hyponatremia, defined as a serum sodium concentration <135 mEq/L, represents the most frequent electrolyte disorder in older hospitalized patients. Early recognition of hyponatremia is mandatory, since it represents an independent risk factor that increases hospital mortality by 40 %. Delayed correction of hyponatremia may worsen brain edema, resulting in different degrees of neural damage. However, an overly rapid correction of serum sodium levels can lead to osmotic demyelination syndrome (ODS), a dreadful neurological picture. In recent years, hyponatremia and ODS have received growing attention both in terms of clinical management and pathophysiology, leading to the discovery of new drugs and treatment algorithms. In this review, we recapitulate the pathogenetic background, clinical manifestations, and treatment guidelines of hyponatremia, focusing on the neurological alterations. Neurological symptoms may be neglected when they manifest as early signs of mild hyponatremia, while brain damage can irremediably affect patients' conditions in the context of ODS.

• Authors: Manuel Alfredo Podestà, Irene Faravelli, David Cucchiari, Francesco Reggiani, Silvia Oldani, Carlo Fedeli, Giorgio Graziani
• Journal: Current neurology and neuroscience reports (Curr Neurol Neurosci Rep) Vol. 15 Issue 4 Pg. 18 (Apr 2015) ISSN: 1534-6293 [Electronic] United States
• PMID: 25724319 (Publication Type: Journal Article, Review)

Chemical References

• Sodium

Topics

• Brain (pathology)
• Central Nervous System Diseases (etiology)
• Humans
• Hyponatremia (complications)
• Sodium (blood)