Title: Hyponatremic Encephalopathy<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p> <strong><u>Hyponatremic Encephalopathy</u></strong></p> <ul> <li> Hyponatremic encephalopathy is a true emergency and due to hypoosmolar-induced cerebral edema.</li> <li> In contrast to the asymptomatic patient with hyponatremia, treatment of hyponatremic encephalopathy is determined by symptoms and not the duration of hyponatremia.</li> <li> Clinical manifestations include nausea, vomiting, headache, confusion, seizures, respiratory failure, and coma.</li> <li> Hypertonic saliine is the treatment of choice <ul> <li> Administer 2 ml/kg 3% hypertonic saline (100 ml in many cases)</li> <li> This will typically raise serum sodium 2 mEq/L</li> <li> In most cases, a 4-6 mEq/L rise will reverse neurologic symptoms</li> </ul> </li> </ul> <fieldset><legend>References</legend>
<p> Archinger SG, Ayus JC. Treatment of hyponatremic encephalopathy in the critically ill. <em>Crit Care Med</em>. 2017; epub ahead of print.</p> </fieldset>