Encephalopathy from Hyponatremia
Authors: Alain Borgeat
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 July 1990Encephalopathy from HyponatremiaAlain Borgeat, MD, Dominique Schwander, MD, Adrien Nicole, MDAlain Borgeat, MDSearch for more papers by this author, Dominique Schwander, MDSearch for more papers by this author, Adrien Nicole, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-1-84_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:According to the report documenting the development of severe hyponatremia in healthy young women after unremarkable elective surgical procedures (1), hyponatremia was noted within 32 hours of the procedure and was further complicated by central diabetes mellitus and insipidus; all patients either died or suffered permanent brain damage. The hyponatremia was attributed to inappropriate secretion of antidiuretic hormone combined with excessive postoperative administration of hypotonic fluid (2) and loss of isotonic fluid (as emesis or nasogastric suction). General anesthesia depresses urinary flow rate, glomerular filtration rate, renal blood flow, and excretion of electrolytes (3). The consistent and...References1. FraserArieff CA. Fatal central diabetes mellitus and insipidus resulting from untreated hyponatremia: a new syndrome. Ann Intern Med. 1990;112:113-9. LinkGoogle Scholar2. Arieff A. Hyponatremia, convulsions, respiratory arrest and permanent brain damage after elective surgery in healthy women. N Engl J Med. 1986;314:1529-35. CrossrefMedlineGoogle Scholar3. Mazze R. Renal physiology and the effects of anesthesia. In: Miller RD, ed. Anesthesia. 2d ed. New York: Churchill Livingstone Inc.; 1986:1123-48. Google Scholar1. FraserArieff CA. Fatal central diabetes mellitus and insipidus resulting from untreated hyponatremia: a new syndrome. Ann Intern Med. 1990;112:113-9. LinkGoogle Scholar2. PlumPosner FJ. Diagnosis of Stupor and Coma. 3d ed. Philadelphia: F.A. Davis; 1982. Google Scholar3. SternsRiggsSchochet RJS. Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314:1535-42. CrossrefMedlineGoogle Scholar1. FraserArieff CA. Fatal central diabetes insipidus and mellitus resulting from untreated hyponatremia: a new syndrome. Ann Intern Med. 1990;112:113-9. LinkGoogle Scholar2. Mazze R. Renal physiology and the effects of anesthesia. In: Miller RD, ed. Anesthesia. 2d ed. New York: Churchill Livingstone Inc.; 1986:1223-48. Google Scholar3. SmithBleck MT. Techniques for determining brain death. J Crit Illness. 1989;4:67-73. Google Scholar4. CogginsLeaf CA. Diabetes insipidus. Am J Med. 1967;42:807-13. CrossrefMedlineGoogle Scholar5. AyusKrathapalliArieff JRA. Treatment of symptomatic hyponatremia and relationship to brain damage: a prospective study. N Engl J Med. 1987;317:1190-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Hôpital Cantonal Fribourg 1700 Fribourg, Switzerland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1990Volume 113, Issue 1Page: 84-86KeywordsBrain damageBrain diseasesDiabetes mellitusExcretionGeneral anesthesiaGlomerular filtration rateHyponatremiaIsotonicityRenal circulationSalts Issue Published: 1 July 1990 PDF downloadLoading ...