Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 9, Number 4, April 2017, pages 266-272

Does Accidental Overcorrection of Symptomatic Hyponatremia in Chronic Heart Failure Require Specific Therapeutic Adjustments for Preventing Central Pontine Myelinolysis?

Figures

Figure 1.
Figure 1. Symptoms of hyponatremia depend on the extent of the electrolytic disorder, but also on the rapidity with which it occurs.
Figure 2.
Figure 2. Correction speed of the serum Na+ in the various phases of therapy.

Table

Table 1. Osmotic Demyelination Syndrome (Otherwise Termed “Central Pontine Myelinolysis”): Main Prodromes and Symptoms
 
Possible observable immediate precursorsFrequently observed symptoms
SeizuresAcute para- or tetra-paresis
Disturbed consciousnessDysphagia
Gait troublesDysarthria
Diplopia
Loss of consciousness
Other neurological symptoms associated with brainstem damage
The patient may experience locked-in syndrome where cognitive function is intact, but all muscles are paralyzed with the exception of eye blinking. This severe clinical picture ensues from a rapid myelinolysis of the corticobulbar and corticospinal tracts in the brainstem.