Hypervolemic hyponatremia increased ECFV a Low urine sodium edematous states

i. Water and sodium restriction (two-thirds maintenance).

ii. Consider loop diuretics. b. High urine sodium. Water restriction (two-thirds maintenance).

Problem Case Diagnosis. The 3-month-old infant had hyponatrem-ic-induced seizures as a result of gastroenteritis. Urine sodium value was < 20 mmol/24 h (normal is 40-120 mmol/24 h). CT scan of the head was normal. Patient showed clinical improvement over the next 2 days once sodium imbalance was gradually corrected.

Teaching Pearl: Question. What neurologic condition is associated with a rapid increase in serum sodium?

Teaching Pearl: Answer. Central pontine myelinolysis develops in patients who experience a rapid increase in serum sodium and hence is a risk factor in treatment of hyponatremia.

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