Therapy of Hyponatremia

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Abstract
Worsening weakness, lethargy, and nausea merge with progressive headache and obtundation to culminate in generalized seizures, coma, and ultimately death. This noxious sequence describes equally well the effects of worsening hyponatremia or hypernatremia and underscores the importance of the central nervous system in syndromes of disordered water balance. In two contributions to this issue, Arieff1 and Sterns and his colleagues2 describe 23 patients with hyponatremia who had fatal or permanently crippling central nervous system effects. Unfortunately, the authors leave unsettled whether it was the severity of the hyponatremia or its speed of correction that caused these neuropathologic complications. Were their . . .