Skip to main content
NCBI home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1986 Jan 18;292(6514):168–170. doi: 10.1136/bmj.292.6514.168

Treatment of hyponatraemic seizures with intravenous 29.2% saline.

L I Worthley, P D Thomas
PMCID: PMC1339038  PMID: 3080118

Abstract

Five patients with severe hyponatraemia and epileptiform seizures were given 50 ml of 29.2% saline (250 mmol) through a central venous catheter over 10 minutes to control seizures rapidly, reduce cerebral oedema, and diminish the incidence of permanent neuronal damage. The saline controlled seizures in all patients, increasing the mean serum sodium concentration by 7.4 (SD 1.14) mmol(mEq)/l and decreasing the mean serum potassium concentration by 0.62 (0.5) mmol(mEq)/l. Further saline and frusemide were then administered over 10 (2) hours, raising the serum sodium concentration by 2.14 (0.49) mmol/l/h until it reached 133 (2.35) mmol/l. A total of 790 (139) mmol saline was infused and a negative fluid balance of 3.34 (0.75) litres achieved. Four patients survived without neurological abnormality. One patient, who was not treated immediately and suffered a prolonged episode of status epilepticus, was left with a permanent neurological defect.

Full text

PDF
168

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arieff A. I., Guisado R. Effects on the central nervous system of hypernatremic and hyponatremic states. Kidney Int. 1976 Jul;10(1):104–116. doi: 10.1038/ki.1976.82. [DOI] [PubMed] [Google Scholar]
  2. Dila C. J., Pappius H. M. Cerebral water and electrolytes. An experimental model of inappropriate secretion of antidiuretic hormone. Arch Neurol. 1972 Jan;26(1):85–90. doi: 10.1001/archneur.1972.00490070103013. [DOI] [PubMed] [Google Scholar]
  3. Fishman R. A. Brain edema. N Engl J Med. 1975 Oct 2;293(14):706–711. doi: 10.1056/NEJM197510022931407. [DOI] [PubMed] [Google Scholar]
  4. Glynn I. M., Karlish S. J. The sodium pump. Annu Rev Physiol. 1975;37:13–55. doi: 10.1146/annurev.ph.37.030175.000305. [DOI] [PubMed] [Google Scholar]
  5. Grainger R. G. Osmolality of intravascular radiological contrast media. Br J Radiol. 1980 Aug;53(632):739–746. doi: 10.1259/0007-1285-53-632-739. [DOI] [PubMed] [Google Scholar]
  6. Hantman D., Rossier B., Zohlman R., Schrier R. Rapid correction of hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. An alternative treatment to hypertonic saline. Ann Intern Med. 1973 Jun;78(6):870–875. doi: 10.7326/0003-4819-78-6-870. [DOI] [PubMed] [Google Scholar]
  7. Kleinschmidt-DeMasters B. K., Norenberg M. D. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science. 1981 Mar 6;211(4486):1068–1070. doi: 10.1126/science.7466381. [DOI] [PubMed] [Google Scholar]
  8. Marsh M. L., Marshall L. F., Shapiro H. M. Neurosurgical intensive care. Anesthesiology. 1977 Aug;47(2):149–163. doi: 10.1097/00000542-197708000-00006. [DOI] [PubMed] [Google Scholar]
  9. Rymer M. M., Fishman R. A. Protective adaptation of brain to water intoxication. Arch Neurol. 1973 Jan;28(1):49–54. doi: 10.1001/archneur.1973.00490190067009. [DOI] [PubMed] [Google Scholar]
  10. Shapiro H. M. Intracranial hypertension: therapeutic and anesthetic considerations. Anesthesiology. 1975 Oct;43(4):445–471. [PubMed] [Google Scholar]
  11. Tomlinson B. E., Pierides A. M., Bradley W. G. Central pontine myelinolysis. Two cases with associated electrolyte disturbance. Q J Med. 1976 Jul;45(179):373–386. [PubMed] [Google Scholar]
  12. Worthley L. I. Rapid correction of water intoxication by hypertonic saline and frusemide. Aust N Z J Med. 1975 Dec;5(6):557–560. doi: 10.1111/j.1445-5994.1975.tb03862.x. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES