Excessive correction of sodium levels can lead to which of the following complications?

Excessive correction of sodium levels is particularly associated with central pontine myelinolysis. This serious and potentially life-threatening condition occurs when there is an overly rapid increase in serum sodium, primarily after treating chronic hyponatremia. The brain is vulnerable to rapid changes in osmolality, and the abrupt shift can lead to demyelination in the central pons, resulting in neurological deficits such as difficulty in motor function, cognitive impairment, and in severe cases, locked-in syndrome.

The mechanism behind this complication involves the fact that neurons adapt to chronic low sodium levels by adjusting their intracellular osmolytes. When sodium is suddenly corrected too rapidly, these neuronal adaptations can lead to cellular injury and demyelination, demonstrating the necessity for a carefully controlled and gradual correction of sodium levels in patients. This underscores the importance of monitoring and managing sodium levels judiciously to prevent such complications.