Correction Of Serum Sodium Research Articles

Mielinólise pontina central e extrapontina: relato de caso com evolução catastrófica

OBJETIVO: Relatar um caso pediatrico de mielinolise pontina central e extrapontina, rara doenca neurologica frequentemente relacionada com a rapida correcao da hiponatremia. DESCRICAO: Adolescente de 15 anos de idade apresentou a sindrome do encarceramento no contexto de hiponatremia grave. Os achados na ressonância magnetica cerebral foram compativeis com o diagnostico de mielinolise pontina central e extrapontina. COMENTARIOS: A correcao do sodio serico deve ser realizada de forma cuidadosa e lenta, respaldada em calculo meticuloso do deficit de sodio, para minimizar o estresse metabolico e evitar a ocorrencia dessa complicacao em potencial, a qual, na grande maioria das vezes, cursa com evolucao catastrofica. Nao existe tratamento eficaz comprovado da mielinolise e, nos casos graves, o prognostico geralmente e reservado.

Severe hyponatraemia: investigation and management in a district general hospital

Aims: To study the incidence, investigation, and management of severe hyponatraemia (serum sodium < 120 mmol/litre) over a period of six months in a district general hospital. Methods: The laboratory...

Central pontine myelinolysis

Central pontine myelinolysis (CPM), a neurologic disorder caused most frequently by rapid correction of hyponatremia, is characterized by demyelination that affects the central portion of the base of the pons. There are no inflammatory changes, and blood vessels are normal. Clinical features usually reflect damage to the descending motor tracts and include spastic tetraparesis, pseudobulbar paralysis, and the locked-in syndrome. Magnetic resonance imaging of the brain, the imaging procedure of choice, shows an area of prolonged T1 and T2 relaxation in the central pons, which may have a characteristic shape. Recovery varies, ranging from no improvement to substantial improvement. To avoid CPM, correction of serum sodium in patients with hyponatremia should not exceed 12 mEq/24 h. We describe a case of CPM in a hyponatremic patient who presented with a cerebellar syndrome with no pyramidal tract involvement and in whom the rate of correction of serum sodium was within the recommended limits.

Central Pontine Myelinolysis: A Multidisciplinary Approach to Care

Central pontine myelinolysis (CPM) is a neurological disorder with a variety of manifestations which may be fatal or result in permanent disabilities. Various factors, most commonly too rapid correction of serum sodium, have been implicated in the development of this osmotic demyelinating syndrome. The patient's survival depends on accurate assessment and prompt intervention by the neuroscience nurse. Optimal outcome depends on collaboration by all members of the health care team.