2014-18 Clinical features Clinical manifestations are related to osmotic ading to increased ICF, specifically brain swell or cerebral ly neurologic and rapidity of onset and Symptoms include headache, lethargy, seizures, and a ogress to coma and death. The severity of these neurologic manifestations depends more on the rate of the hypotonic decline in plasma sodium If a patient survives the acute hyponatremia, osmotic adaptation tends to mitigate the symptoms of cerebral edema t↓ Treatment Treatment of hyponatremia varies depending on the It is the importance of identifying and treating any underlying disorder urologic status, and any information about recent2014-1-8 6 Clinical features • Clinical manifestations are related to osmotic water shift leading to increased ICF, specifically brain swell or cerebral edema. Therefore, the symptoms are primarily neurologic and their severity is dependent on the rapidity of onset and absolute decrease in plasma [Na+]. • Symptoms include headache, lethargy, seizures, and a progressively decreased level of consciousness that can progress to coma and death. • The severity of these neurologic manifestations depends more on the rate of the hypotonic decline in plasma sodium concentration. • If a patient survives the acute hyponatremia, osmotic adaptation tends to mitigate the symptoms of cerebral edema. Treatment • Treatment of hyponatremia varies depending on the category and underlying diagnosis • It is the importance of identifying and treating any underlying disorder • The sodium concentration and the rate of correction should be guided by the patient’s age, gender, neurologic status, and any information about recent past plasma sodium concentrations or osmolality values