Seizure Following Oral Rehydration of Hypernatremia with Water

Kishaba, R. Gregg; Losek, Joseph D.; Eisenberg, Carl

doi:10.1177/000992289002900408

Cited by 4 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…26 Si en un estado hipernatrémico (hiperosmolar) se hace una corrección rápida, la mayor parte de las células del cuerpo se rehidratarán de forma adecuada; sin embargo, en el cerebro que ha mantenido su volumen intracelular entrará líquido, igualmente rápido, desde el espacio extracelular que llevará a la neurona a edema. En el curso de la rehidratación se han descrito convulsiones y edema cerebral; [27][28] la patogénesis se describió hace más de 50 años. 29 Para el tratamiento de la hipernatremia se recomienda la corrección lenta, a una velocidad no mayor de 0.5 mEq/L/h de sodio sérico, [30][31] para evitar edema cerebral.…”

Section: Fisiopatologíaunclassified

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

Candiani

2019

Acta Pediatr Mex

View full text Add to dashboard Cite

La hipernatremia (sodio sérico 145 mEq/L) es un desequilibrio que, cuando es grave (160 mEq/L), puede causar alteraciones vasculares y neurológicas agudas, dejar secuelas graves o causar la muerte en recién nacidos.1-4 Se han descrito: trombosis del seno sagital superior,5-6 aórtica 7-8 mesentérica, renal, iliaca, femoral, poplítea7 y arteria retinal;9 hemorragia parenquimatosa,10 gangrena distal,7,11-12 enterocolitis necrosante,13 hipertensión arterial pulmonar e insuficiencia cardiaca derecha.14 La patogénesis de las lesiones cerebrales se describió hace más de medio siglo,15 muchas secundarias a una corrección inadecuada. Oddie16 informa una incidencia de 7 x cada 100,000 nacidos vivos. Se trata, en sí, de un trastorno de la concentración relativa de sodio en el espacio extracelular, y no necesariamente de la cantidad de sodio corporal total que puede estar elevada o ser normal; puede asociarse con volumen de agua corporal normal, alto o bajo.

show abstract

Section: Fisiopatologíaunclassified

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

Candiani

2019

Acta Pediatr Mex

View full text Add to dashboard Cite

show abstract

“…Some complications can be iatrogenic and directly related to the management of hypernatremia. Examples include brain edema with raised intracranial pressure in relation to a relatively rapid rehydration [88,91]. Another example is the occurrence of pontine myelinolysis, also called osmotic demyelination syndrome, which relates to brain cell dysfunction caused by the destruction of the myelin sheath covering nerve cells in the brainstem.…”

Section: Complications Of Hypernatremiamentioning

confidence: 99%

Hypernatremia in children

Narchi

2016

J Pediatr Biochem

View full text Add to dashboard Cite

Hypernatremia results from a deficit of total body water in relation to the total body's sodium stores. This is caused by two main mechanisms: 1) net water depletion exceeding sodium losses or 2) increased sodium gain exceeding water gain. Net water depletion occurs when increased water loss exceeds sodium loss, either due to extrarenal losses (increased evaporative water losses, hypernatremic dehydration caused by diarrhea) or to renal losses (central and nephrogenic diabetes insipidus, intrinsic renal disease). Insufficient water intake occurs with neonatal hypernatremic dehydration secondary to lactation failure, essential hypernatremia or osmoreceptor dysfunction. Increased sodium gain can be caused by iatrogenic hypernatremia, administration of concentrated infant formula, deliberate abusive water restriction and deliberate or non-accidental salt poisoning. Hypernatremia results in a movement of water across cell membranes from the intracellular to the extracellular space, resulting in cellular dehydration, which, in cells of the central nervous system results in brain shrinkage leading to tearing of cerebral blood vessels and neurological complications. As a protective mechanism, idiogenic osmoles accumulate inside the brain cells to help them retain water intracellularly. However this may lead to cerebral edema during rapid rehydration as these idiogenic osmoles attract water inside the neurons. As the appropriate management of hypernatremia invariably depends on the underlying mechanism and cause, a methodical history taking and clinical examination, with the judicious use of laboratory tests will lead to a precise etiological diagnosis to enable appropriate and timely therapy.

show abstract

“…123 Similarly, hypocalcemic seizures are usually seen in neonates fed with high-phosphate milk formulas and rarely in adults following complete parathyroidectomy or due to alebdronate-induced hypocalcemia. 124,125 Seizures are usually preceded by signs of tetany, perioral and limb paresthesias, confusion, and/or papilledema.…”

Section: Electrolyte and Metabolic Abnormalitiesmentioning

confidence: 99%

Management of Seizures in the Critically Ill

Varelas¹,

Spanaki²

2006

The Neurologist

View full text Add to dashboard Cite

Seizures in a critically ill patient are not infrequent phenomena. Physicians are perplexed by the wide range of possible cranial or extracranial etiologies, alerted by the risk for further crucial organ compromise if seizures recur, and confused about the treatment options in an environment rich in complex drug interactions and multiple organ dysfunction. The advent of an armamentarium containing multiple new antiepileptic medications complicates the situation further, since several of them have less known mechanisms of action, side effects, or interactions with other intensive care unit (ICU) medications. This review contains useful information regarding the most common etiologies and treatment options for intensivists, consulting neurologists, neurosurgeons, or other specialized physicians treating ICU patients with seizures.

show abstract

Seizure Following Oral Rehydration of Hypernatremia with Water

Cited by 4 publications

References 9 publications

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

Hypernatremia in children

Management of Seizures in the Critically Ill

Contact Info

Product

Resources

About