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.

Neurological Counterparts of Hyponatremia : Pathological Mechanisms and Clinical Manifestations / M.A. Podestà, I. Faravelli, D. Cucchiari, F. Reggiani, S. Oldani, C. Fedeli, G. Graziani. - In: CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS. - ISSN 1528-4042. - 15:4(2015), pp. 18.1-18.10.

Neurological Counterparts of Hyponatremia : Pathological Mechanisms and Clinical Manifestations

M.A. Podestà
Co-primo
;
I. Faravelli
Co-primo
;
D. Cucchiari;G. Graziani
Ultimo
2015

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.
Central nervous system; Hyponatremia; Osmotic demyelination syndrome; Pathogenesis; Therapy; Brain; Central Nervous System Diseases; Humans; Hyponatremia; Sodium
Settore MED/14 - Nefrologia
Settore MED/26 - Neurologia
Settore MED/13 - Endocrinologia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/747699
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