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[1] [3] Severe symptoms include confusion, seizures, and coma; [1] [2] [9] death can ensue. [10] The causes of hyponatremia are typically classified by a person's body fluid status into low volume, normal volume, or high volume. [4] Low volume hyponatremia can occur from diarrhea, vomiting, diuretics, and sweating. [4]
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used.[2]When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
Hypernatremia (high blood sodium level, above 145 mEq/L) causes thirst, and due to brain cell shrinkage may cause confusion, muscle twitching, or spasms. With severe elevation, seizures and comas may occur. [11] [12] Death can be caused by ingestion of large amounts of salt at a time (about 1 g per kg of body weight). [13]
Examples of causes of provoked seizures that can be corrected include low blood sugar, low blood sodium, febrile seizures in children, and substance/medication use. Starting anti-seizure medications is usually for those with medium to high risk of seizures re-occurring.
In addition to eating less high-sodium processed foods, the experts recommend opting for no or low-sodium products and cooking with less salt. "No salt shaker on the table," Schnoll-Sussman says.
Considerations for treatment include symptom severity, time to onset, volume status, underlying cause, and sodium levels. [14] If the sodium level is <120 mEq/L, the person can be treated with hypertonic saline as extremely low levels are associated with severe neurological symptoms. [14]
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