Signs and Symptoms of Hyponatremia

Having hyponatremia can be really troublesome, so it is very crucial to recognize the signs and symptoms.  Since sodium helps with muscle and nerve conduction, many of the symptoms are related to defects in that specific area. According to Medline, common signs and symptoms of hyponatremia include: confusion, convulsions, fatigue, headache, irritability, loss of appetite, muscle spasms or cramps, muscle weakness, nausea, restlessness, and vomiting.  Complications from rapidly evolving and severe hyponatremia are more neurologic. and much more serious.  The symptoms include: seizures, coma, permanent brain damage, respiratory arrest, brain-stem herniation, and in the worst case scenario: death (3).  For acute severe hyponatremia (sodium concentration of <115mm), patients usually always present with symptoms.  Acute severe hyponatremia usually presents with neurologic symptoms that include drowsiness and disorientation to coma, grand mal seizures, and respiratory arrest (2).  These symptoms can be very dangerous and should be corrected immediately.  Chronic severe hyponatremia is a slightly different story.  The symptoms of hyponatremia are usually involves mild to moderate symptoms.  In chronic hyponatremia, brain volume regulation is intact, so thus neurologic symptoms are not apparent (there is no evidence of brain swelling) (2). Severe chronic hyponatremia is commonly observed in the advanced stages of he inappropriate secretion of antidiuretic hormone, cardiac failure, and liver cirrhosis.  It does not appear to case major problems by itself (2).  In a study done by physicians in the Journal of the Association of Physicians of India, the most common presenting symptoms were: Lethargy, irrelavant speech, and drowsiness (4).  This is very apparent in the graph below:

Patients Admitted to the Hospital With Symptoms Attributable to Hyponatremia

Prevalence of Hyponatremia Types 

Various Causes of Hyponatremia

Works Cited

1 . Dugdale, D. (2014, April 14). Hyponatremia: MedlinePlus Medical Encyclopedia. Retrieved April 29, 2015, from http://www.nlm.nih.gov/medlineplus/ency/article/000394.htm

2. Gross, P., Reimann, D., Henschkowski, J., & Damian, M. (2001). Treatment of Severe Hyponatremia: Conventional and Novel Aspects. Journal of the American Society of Nephrology, 12, S10-S14. Retrieved April 29, 2015, from http://jasn.asnjournals.org/content/12/suppl_1/S10.full

3. Hospital-associated hyponatremia is an important predictor of morbidity and mortality1. (2014, June 1). Retrieved May 3, 2015, from http://www.hyponatremiaupdates.com/serious-threat.aspx

4.Rao, M., Sudhir, U., Kumar, A., Saravanan, S., Mahesh, E., & Punith, K. (2010). Hospital-Based Descriptive Study of Symptomatic Hyponatremia in Elderly Patients. Journal of the Association of Physicians of India, 58. Retrieved April 30, 2015, from http://www.japi.org/november_2010/article_03.html