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 a side effect of certain medicines, lung problems such as pneumonia or abscess, brain disease, or certain cancers (most often small cell lung carcinoma). The cornerstone of therapy for SIADH is reduction of water intake. If hyponatremia persists, then demeclocycline (an antibiotic with the side effect of inhibiting ADH) can be used. SIADH can also be treated with specific antagonists of the ADH receptors, such as conivaptan or tolvaptan. Another cause is psychogenic polydipsia. A third group of people with hyponatremia are often said to be "hypervolemic". They are identified by the presence of peripheral edema. In fact, the term