Central Pontine Myelinolysis after Slow Correction of Hyponatremia

This week’s Images in Clinical Medicine is a case that demonstrates how little we know about hyponatremia.

35 year old alcoholic.
Severe hyponatremia with a sodium of 119.
The sodium was corrected over 5 days from 119 to 135. A rate of only 3 mmol/L/day.
Patient developed CPM on the sixth day.

Kenar has a nice post on this case with an alternative approach to try to protect patients.