Hyponatremia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
Symptoms associated with hyponatremia are caused mostly by impairment of brain function. There is a spectrum of signs from no detectable presentation to death. To evaluate the causes of hyponatremia, careful history has to be taken. Drug history and past medical history can lead to the most common causes of hyponatremia.
History and Symptoms
- Drug history
- Diet history
- History of volume loss: Diarrhea, vomiting
- History of decreased urine output
- Chronic illnesses: CHF, RF
- History of endocrine disorders
- History of malignancy
- History of infectious diseases
- History of psychiatric illnesses
- History of diagnostic procedures or operations
- History of blood disorders
- History of CNS disorders
- History of pulmonary diseases
- History of genetic diseases: Hyperlipidemia, nephrogenic SIAD, RTA
- History of diabetes
- History of GI disorders
To see the different causes of hyponatremia, click here.
Common Symptoms
The clinical signs and symptoms of hyponatremia are related to the degree of brain compensation to hypoosmolarity. Development of cerebral edema, increased intracerebral pressure and cerebral hypoxia are responsible for hyponatremia presentation. Also see the complications of hyponatremia.
- Asymptomatic
- Acute neurologic changes: seizures, altered mental status, coma , focal neurologic signs like one-sided facial droop, opposite-sided hemiparesis, dysarthria and aphasia in hyperacute hyponatremia. [1]
- Moderate symptoms
- Nausea
- Malaise
- Headache
- Confusion
- Loss of energy and fatigue
- Restlessness and irritability
- Muscle weakness, spasms or cramps
- Fatigue
- Lethargy
- Dizziness
- Gait disturbances
- Forgetfulness
- Severe
- Vomiting
- Cardio-respiratory distress
- Abnormal and deep somnolence
- Seizures [2]
- Coma (Glasgow Coma Scale 8)
- Delirium
- Impaired consciousness
- Mild chronic hyponatremia (plasma sodium 125–135 mEq/L) may cause subtle neurocognitive deficits that can be detected by careful testing ,these deficits improve when the plasma sodium is normalized.[3]
- COVID-19 pneumonia patients have been found to develop SIADH and severe hyponatremia in some cases causing seizures. [2]
Less Common Symptoms
References
- ↑ Balbi, Alanna; Sadowski, Jennifer A.; Torrens, Daniel; Jacoby, Jeanne L.; Yacoub, Hussam A.; Eygnor, Jessica K. (2021). "Hyperacute hyponatremia mimicking acute ischemic stroke: A case report". The American Journal of Emergency Medicine. doi:10.1016/j.ajem.2021.07.017. ISSN 0735-6757.
- ↑ 2.0 2.1 Habib, Mhd Baraa; Hamad, Mohammad Khair; Kalash, Tarif; Ahmed, Ashraf; Mohamed, Mouhand F (2021). "COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia". Cureus. doi:10.7759/cureus.15603. ISSN 2168-8184.
- ↑ F. C. Bartter & W. B. Schwartz (1967). "The syndrome of inappropriate secretion of antidiuretic hormone". The American journal of medicine. 42 (5): 790–806. PMID 5337379. Unknown parameter
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