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CNS Manifestations of Hyponatremia and Its Treatment

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Hyponatremia

Abstract

Hyponatremia is by far the commonest electrolyte disorder encountered in the clinical practice. The extracellular osmolarity is an important determinant of action potential conduction in neurons as well as glial cell volume. Neurological impairment is a widely recognised complication of hyponatremia and this occurs as a result of the failure of brain adaptative mechanisms to low serum osmolarity or abrupt osmotic changes. Because the brain is enclosed in a rigid skull, any changes in the brain volume induced by a decreased extracellular osmolarity could potentially result in severe symptoms like seizure or fatal brain herniation. On the other hand it has been established that rapid correction of hyponatremia is the principal risk factor for osmotic demyelination syndrome (ODS) which is a peculiar disorder characterised by loss of myelin in specific regions of the central nervous system.

This chapter will review the mechanisms of brain adaptation to hyponatremia as well as the pathophysiology of the neurological manifestations of hyponatremia including ODS.

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Authors and Affiliations

  1. Department of General Internal Medicine, Hopital Universitaire Erasme, 8080 route de lennik, 1070, Bruxelles, Belgium

    Fabrice Gankam Kengne & Guy Decaux

  2. Department of General Internal Medicine, Université Libre de Bruxelles, Research Unit on Hydromineral Metabolism, Bruxelles, Belgium

    Fabrice Gankam Kengne & Guy Decaux

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  1. Fabrice Gankam Kengne
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  2. Guy Decaux
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Correspondence to Fabrice Gankam Kengne .

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  1. Section of Nephrology and Hypertension, Tulane University Health Sciences Center, Tulane Ave 1430, New Orleans, 70112, Louisiana, USA

    Eric E. Simon

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Kengne, F.G., Decaux, G. (2013). CNS Manifestations of Hyponatremia and Its Treatment. In: Simon, E. (eds) Hyponatremia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6645-1_5

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