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November 1967

Hyponatremia in Acute Polyneuropathy: Four Cases With the Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Author Affiliations

New York
From the Department of Neurology, Cornell University Medical College (Dr. Posner); Department of Medicine, State University of New York (Dr. Ertel); Department of Ophthalmology, Columbia University College of Physicians and Surgeons (Dr. Kossmann); and Department of Neurology, Albert Einstein College of Medicine (Dr. Scheinberg), New York.

Arch Neurol. 1967;17(5):530-541. doi:10.1001/archneur.1967.00470290084011

HYPONATREMIA is a widely recognized complication of several central nervous system (CNS) disorders. Recent reports of hyponatremia in subarachnoid hemorrhage1 and herpes simplex encephalitis2 have added to a long list which includes meningitis,3 head injuries,4 brain tumors,5 and a variety of other CNS illnesses.6-8 The recognition of this complication is clinically important since hyponatremia per se may cause delirium, tremor, and convulsions, and thus create a problem in diagnosis or additionally insult an already damaged nervous system. It is less widely recognized that hyponatremia complicates "acute para-infectious" polyneuropathy, an illness usually considered to be restricted to the peripheral nervous system.9 To our knowledge, only three such cases have been reported;10-12 and in all, the lowered serum sodium produced no symptoms. This paper reports four cases of severe hyponatremia associated with, and complicating the course of, pareinfectious polyneuropathy. The evidence suggests that

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