This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

R. F. Gledhill, MD, MRCP
Division of Neurology Department of Internal Medicine Kalafong Hospital and the University of Pretoria Pretoria 0001, South Africa

P. D. Thompson, MB, FRACP
University Department of Neurology Kings College Hospital Medical School and Institute of Psychiatry London, England

Arch Neurol. 1989;46(4):359.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In describing a patient with central pontine myelinolysis (CPM) and behavioral symptoms, Price and Mesulam¹ considered the development of CPM to be related to the rapid correction of hyponatremia. The serum sodium concentration in this patient on admission was 114 mmol/L and 17 hours later it was 133 mmol/L, yielding a calculated rate of correction of 1.12 mmol/L/h. That being so, we find it curious that, in discussing their case, the authors quote rates of correction (for sodium concentrations of 105 mmol/L) of 2 mmol/L/h² as being advisable. Indeed, from their own experience, we would have expected them to have joined the vanguard advocating a slower rate of correction,^3,4 particularly as the only symptom of hyponatremia in their patient was orthostatic hypotension. Thus, in a situation of this nature it might have been preferable to increase the serum sodium concentration at a rate not . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?