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Severe symptomatic hyponatraemia — SCE Endocrinology MCQ

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EasyEndocrine emergencies/dynamic testsSevere symptomatic hyponatraemiaSCE Endocrinology

A 26-year-old woman has severe headache, vomiting and a generalised seizure. Sodium is 112 mmol/L. She is drowsy and euvolaemic on examination. What is the most appropriate immediate management?

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Correct answer: B — Hypertonic saline bolus with close sodium monitoring

Severe symptomatic hyponatraemia with seizure requires immediate hypertonic saline regardless of cause. Fluid restriction alone is too slow for life-threatening symptoms. Correction must be carefully monitored to reduce osmotic demyelination risk.

Reference: Society for Endocrinology Hyponatraemia Emergency Guidance