Central pontine myelinolysis scenario the CPM is caused by polydipsia leading to low blood sodium levels (hyponatremia). In schizophrenic patients with psychogenic polydipsia, inadequate thirst reception leads to excessive water intake, severely diluting serum sodium. With this excessive thirst combined with psychotic symptoms, brain damage such as CPM may result from hyperosmolarity caused by excess intake of fluids, (primary polydipsia) although this is difficult to determine because such patients are often institutionalised and have a long history of mental health conditions. It has been observed following hematopoietic stem cell transplantation. CPM may also occur in patients prone to hyponatraemia affected by: The currently
Hyponatremia arrest, and non-cardiogenic accumulation of fluid in the lungs. This is usually fatal if not immediately treated. Symptom severity depends on how fast and how severe the drop in blood salt level. A gradual drop, even to very low levels, may be tolerated well if it occurs over several days or weeks, because of neuronal adaptation. The presence of underlying neurological disease such as a seizure disorder or non-neurological metabolic abnormalities, also affects the severity of neurologic symptoms. Chronic hyponatremia can lead to such complications as neurological impairments. These neurological impairments most often affect gait (walking) and attention, and can