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Complications of Acute hyponatremia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   My daughter-in-law suffered severe brain injury two weeks ago from a seizure brought about by low sodium. For a few days she was moving her arms and legs a lot, trying to get out of bed, and she attempted to speak. Just today she slipped back into a coma. Is that "normal" in recovery -- slipping in and out of coma?
Doctor :   Hi
User :   Hello
Doctor :   Ok, I have seen your query .
Doctor :   May I know her Glasgow coma scale now ?
User :   I don't know that. Before today she was opening her eyes and responding to light and to pain. I would guess from the description of the Glasgow coma scale she is in the severe range. Her MRI showed damage to all areas of the cerebral cortex. She left ICU last week and has been in Hospital for a few days. I was there until Monday, am just getting bits of information now.
Doctor :   Ok,In cases of Acute Hyponatremia , cerebral complications , coma and death occur more often in geriatric patients , and the younger group recover well.
User :   My daughter-in-law is 40.
Doctor :   But if the patient has 3-5 Glasgow coma scale it is very difficult to recover, as there can be permanent brain damage.
Doctor :   Severe hyponatremia (
User :   I don't think her doctors have told my son or anyone else what her Glasgow coma score is. I will try to find that out. Is slipping back into a coma a sign that she won't come out of that state again? In other words is it a regressive stage in recovery or a temporary setback that occurs often?
User :   Her sodium level was 96.
Doctor :   Ok, That is very low .
Doctor :   How did this happen ?
User :   It appears to have been from a combination of a new blood pressure medication with a diuretic (she had taken it for 3 days when she was stricken) and excessive water intake. (She drank glass after glass.) When you say mortality is 50% does a patient die of heart or respiratory failure or only after a feeding tube is removed?
Doctor :   I am sorry to say this, It might be a regressive stage and she might be slipping back into deeper coma.
Doctor :   Acute hyponatremia can lead to much more serious complications including brain disease, brain herniation, cardiopulmonary arrest & cerebral edema.
User :   Yes, that is what I suspect. Is it possible her heart will give out on its own? My son is facing the possibility of ending her feeding and giving her "comfort care" through hospice.
Doctor :   In most of the cases there is a cardio-pulmonary arrest.
Doctor :   The heart would give out on its own.
Doctor :   Or due to cerebellar herniation there might be a brain death , leading to CP Arrest,
Doctor :   But i would suggest please get a coma scale level today
Doctor :   if it is 7
Doctor :   there are chances of recovery
Doctor :   and very good chances as she is 40.
Doctor :   Take care, bye for now.
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