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
Hypotonic hyponatremia said than done when one recognizes that the responsible underlying conditions are diseases such as liver cirrhosis or heart failure — conditions that are notoriously difficult to manage, let alone cure. High volume. There is retention of water. Placing the patient on water restriction can also help in these cases. Hypotonic hyponatremia Hypoosmolar hyponatremia is a condition where hyponatremia associated with a low plasma osmolality. The term "hypotonic hyponatremia" is also sometimes used. When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume. Loss of