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December 22/29, 1999

Treatment of Hyponatremic Encephalopathy

Author Affiliations

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(24):2298-2299. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-24-jbk1222

To the Editor: The article by Drs Ayus and Arieff1 adds another 34 patients to the authors' extensive experience with permanent or fatal brain damage from hyponatremia. In the past 15 years, Ayus and Arieff have reported more than 200 such patients referred to them after a respiratory arrest or hypoxic event; the authors apparently played no role in the management of these cases.1,2 During the same period, the authors directed the treatment of 49 patients with symptomatic hyponatremia1,3; no patient developed a respiratory arrest or hypoxic event and all recovered without sequelae. Apparently, to be treated for hyponatremia by the authors guarantees protection from hypoxia before treatment and brain damage after it; to be treated by anyone else risks almost certain respiratory arrest, death, or disability.