Julian Seifter; Martin A. Samuels Internal Medicine p. 85-90 February 2005, Vol.11, No.1 doi: 10.1212/01.CON.0000293719.78615.94
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Electrolyte disorders are a common cause for neurological dysfunction in medically ill patients. Hyperosmolarity is frequently seen in neurological patients who have become volume depleted for an array of reasons ranging from their underlying neurological disease to the toxicity of many drugs and the effects of common metabolic disturbances such as hyperglycemia. Hyponatremia may develop slowly over many weeks or months with few neurological manifestations or may occur rapidly, leading to seizures and malignant cerebral edema. Treatment depends on an understanding of the brain's mechanisms for compensating for alterations in serum sodium concentrations. Correction of chronic hyponatremia should be done slowly and with great caution, while correction of acute hyponatremia requires rapid and aggressive management in order to prevent death from brain swelling. The management of hypokalemia and hyperkalemia depends upon understanding the metabolic handling of this electrolyte that is so important for the normal function of muscle, including that in the heart and its conducting system.

© 2005 American Academy of Neurology