Answer
Answer
Severe hyponatremia is diagnosed in a person who presents to the emergency department with delirium. Electrolyte disturbances frequently cause encephalopathy. IV fluid therapy is administered, and serum sodium is normal by the next day. The patient's mental status improves, and he or she is more alert, but this is followed by neurologic deterioration 48-72 hours later.
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T2-weighted MRI scan of the brain demonstrating patchy areas of signal change within the pons that are consistent with demyelination or central pontine myelinolysis. Courtesy of Dr Andrew Waclawik, Department of Neurology, University of Wisconsin, Madison.
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