What is your approach to management of severe hyponatremia in patients with alcohol use disorder who experience seizures that could be secondary to the electrolyte derangement or alcohol withdrawal?

Since it is difficult to make a definitive distinction as to whether the seizure is due to severe hyponatremia or alcohol withdrawal, it is prudent to treat both severe hyponatremia and alcohol withdrawal concurrently. Given that the seizure may be contributed to by the severe hyponatremia, 3% hyper...

I would assume the seizures are from the hyponatremia if the serum sodium is less than 115 to 118 mEq/L. I would correct it by 3 to 5 mEq/L in the first 6 to 8 hours and then would correct by 6 to 8 mEq/L in the first 24 hours.