Association between rise in serum sodium and central pontine myelinolysis
Article first published online: 7 OCT 2004
Copyright © 1982 American Neruological Association
Annals of Neurology
Volume 11, Issue 2, pages 128–135, February 1982
How to Cite
Norenberg, M. D., Leslie, K. O. and Robertson, A. S. (1982), Association between rise in serum sodium and central pontine myelinolysis. Ann Neurol., 11: 128–135. doi: 10.1002/ana.410110204
- Issue published online: 7 OCT 2004
- Article first published online: 7 OCT 2004
- Manuscript Accepted: 7 JUN 1981
- Manuscript Revised: 2 JUN 1981
- Manuscript Received: 16 MAR 1981
- Supported by the Medical Research Service of the Veterans Administration and by Grant CA-09157-05 from the National Institutes of Health.
Twelve hyponatremic patients with central pontine myeliolysis (CPM) showed a rise in serum sodium levels 3 to 10 days (mean, 6) prior to the development of CPM. The increase exceeded 20 mEq/L within 1 to 3 days and was then sustained for an additional 3 to 5 days. In addition, 11 of the 12 CPM patients achieved a sodium value of 147 mEq/L or greater during the period of sodium elevation. The rise in sodium frequently coincided with administration of saline solutions, diuretics, steroids, and lactulose. In contrast, 9 hyponatremic patients who did not have CPM showed sodium increases that were significantly less of slower (or both) following treatment of hyponatremia. Our findings suggest that CPM may be caused by a too rapid or excessive rise in serum sodium from a hyponatremic baseline.