Abnormal Presentation of Severe Hyponatremia

Hyponatremia can be a life-threatening condition. Our patient presented alert and oriented, with bilateral upper and lower extremity weakness and gastrointestinal concerns. Labs demonstrated significant hyponatremia at 103 mEq/L, which is inconsistent with her lack of neurological symptoms. It is very rare to have such severe hyponatremia without altered mentation, seizures, or coma. Careful correction of sodium must be completed, and if it is done too quickly, there is a risk of osmotic demyelination syndrome. This makes hyponatremia and its treatment of the utmost importance.