{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:43:07Z","timestamp":1791837787834,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,5,14]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Electrolyte disorders are common in clinical practice and can occur as a consequence of primary neurological disease or as a complication of general medical disorders or critical illness. They may affect fluid shifts, cause disordered transmembrane potential or disrupt neurotransmission. Disorders of sodium, potassium, calcium, phosphate and magnesium metabolism are associated with a range of neurological complications that cause neuromuscular and central neurological disturbance. It is important to distinguish between acute and chronic hyponatraemia because prevention of long-term complications depends on appropriate management. Acute hyponatraemia can rarely cause cerebral oedema, seizures or encephalopathy. Potassium metabolism disorders are associated with cardiac and neuromuscular abnormalities. Calcium derangement can give neurological manifestations that range from mild and non-specific symptoms to encephalopathy. Phosphate and magnesium disturbances are particularly associated with neuromuscular weakness and are important causes of respiratory impairment and failure to wean from ventilatory support in critically ill patients.<\/jats:p>","DOI":"10.1136\/pn-2023-003801","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T18:45:23Z","timestamp":1750013123000},"page":"303-312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Neurological aspects of electrolyte disorders"],"prefix":"10.1136","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-714X","authenticated-orcid":false,"given":"Robin S","family":"Howard","sequence":"first","affiliation":[{"name":"Medical Intensive Care Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravindhan","family":"Baheerathan","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Brown","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Spillane","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manprit","family":"Waraich","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,15]]},"reference":[{"key":"2025090409340737000_25.4.303.1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1159\/000493234","article-title":"Etiology and Epidemiology of Hyponatremia","volume":"52","author":"Burst","year":"2019","journal-title":"Front Horm Res"},{"key":"2025090409340737000_25.4.303.2","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1212\/CON.0000000000000872","article-title":"Electrolyte Disorders and the Nervous System","volume":"26","author":"Jacoby","year":"2020","journal-title":"Continuum (Mount Lawley)"},{"key":"2025090409340737000_25.4.303.3","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/B978-0-444-63599-0.00038-7","article-title":"Neurologic manifestations of major electrolyte abnormalities","volume":"141","author":"Diringer","year":"2017","journal-title":"Handb Clin Neurol"},{"key":"2025090409340737000_25.4.303.4","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/B978-0-7020-4086-3.00023-0","article-title":"Neurologic complications of electrolyte disturbances and acid-base balance","volume":"119","author":"Espay","year":"2014","journal-title":"Handb Clin Neurol"},{"key":"2025090409340737000_25.4.303.5","doi-asserted-by":"crossref","unstructured":"Levin D , Glasheen JJ . Neurohospitalist medicine. In: Josephson SA , Freeman WD , Likosky DJ , eds. Neurological Complications of Electrolytes. Cambridge University Press, 2011: 85\u201396.","DOI":"10.1017\/CBO9780511736193.007"},{"key":"2025090409340737000_25.4.303.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404489"},{"key":"2025090409340737000_25.4.303.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.11176"},{"key":"2025090409340737000_25.4.303.8","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s12028-012-9805-y","article-title":"Hyponatremia and brain injury: historical and contemporary perspectives","volume":"18","author":"Kirkman","year":"2013","journal-title":"Neurocrit Care"},{"key":"2025090409340737000_25.4.303.9","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010111127"},{"key":"2025090409340737000_25.4.303.10","doi-asserted-by":"crossref","first-page":"20420188221097343","DOI":"10.1177\/20420188221097343","article-title":"The management of acute and chronic hyponatraemia","volume":"13","author":"Lawless","year":"2022","journal-title":"Ther Adv Endocrinol Metab"},{"key":"2025090409340737000_25.4.303.11","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.3390\/jcm3041163","article-title":"Effects of Hyponatremia on the Brain","volume":"3","author":"Giuliani","year":"2014","journal-title":"J Clin Med"},{"key":"2025090409340737000_25.4.303.12","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ekir.2017.08.015","article-title":"Hyponatremia and the Brain","volume":"3","author":"Gankam Kengne","year":"2018","journal-title":"Kidney Int Rep"},{"key":"2025090409340737000_25.4.303.13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1159\/000493237","article-title":"Hyponatremia Is Linked to Bone Loss, Osteoporosis, Fragility and Bone Fractures","volume":"52","author":"Barsony","year":"2019","journal-title":"Front Horm Res"},{"key":"2025090409340737000_25.4.303.14","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1210\/jc.2015-4228","article-title":"Association Between Hyponatremia, Osteoporosis, and Fracture: A Systematic Review and Meta-analysis","volume":"101","author":"Upala","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2025090409340737000_25.4.303.15","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/cen.13790","article-title":"Hyponatremia, falls and bone fractures: A systematic review and meta-analysis","volume":"89","author":"Corona","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025090409340737000_25.4.303.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0080451","article-title":"Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis","volume":"8","author":"Corona","year":"2013","journal-title":"PLoS One"},{"key":"2025090409340737000_25.4.303.17","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.amjmed.2016.03.007","article-title":"The Economic Burden of Hyponatremia: Systematic Review and Meta-Analysis","volume":"129","author":"Corona","year":"2016","journal-title":"Am J Med"},{"key":"2025090409340737000_25.4.303.18","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016101139"},{"key":"2025090409340737000_25.4.303.19","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-1020"},{"key":"2025090409340737000_25.4.303.20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2215\/CJN.0000000000000244","article-title":"Treatment Guidelines for Hyponatremia: Stay the Course","volume":"19","author":"Sterns","year":"2024","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025090409340737000_25.4.303.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.11.010"},{"key":"2025090409340737000_25.4.303.22","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2015-133740"},{"key":"2025090409340737000_25.4.303.23","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-59602-4.00003-4"},{"key":"2025090409340737000_25.4.303.24","first-page":"33","article-title":"Management of euvolemic hyponatremia attributed to SIADH in the hospital setting","volume":"39","author":"Peri","year":"2014","journal-title":"Minerva Endocrinol"},{"key":"2025090409340737000_25.4.303.25","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ccc.2018.11.001","article-title":"Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone in Critically Ill Patients","volume":"35","author":"Harrois","year":"2019","journal-title":"Crit Care Clin"},{"key":"2025090409340737000_25.4.303.26","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1159\/000493243","article-title":"Adverse Consequences of Overly-Rapid Correction of Hyponatremia","volume":"52","author":"Sterns","year":"2019","journal-title":"Front Horm Res"},{"key":"2025090409340737000_25.4.303.27","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13150"},{"key":"2025090409340737000_25.4.303.28","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2004.045906"},{"key":"2025090409340737000_25.4.303.29","doi-asserted-by":"crossref","first-page":"106811","DOI":"10.1016\/j.clineuro.2021.106811","article-title":"Osmotic demyelination syndrome improving after immune-modulating treatment: Case report and literature review","volume":"208","author":"Kalampokini","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"2025090409340737000_25.4.303.30","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318236f152"},{"key":"2025090409340737000_25.4.303.31","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02950319"},{"key":"2025090409340737000_25.4.303.32","doi-asserted-by":"publisher","DOI":"10.1530\/EC-18-0109"},{"key":"2025090409340737000_25.4.303.33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11154-016-9384-x","article-title":"Updates in hyperkalemia: Outcomes and therapeutic strategies","volume":"18","author":"Kovesdy","year":"2017","journal-title":"Rev Endocr Metab Disord"},{"key":"2025090409340737000_25.4.303.34","doi-asserted-by":"crossref","unstructured":"Morrow J , Hanna M , Parton M . Chapter 18. neurology: a queen square textbook. In: Robin H , Dimitri K , David W , et al , eds. Disorders of Muscle. 3rd edn. John Wiley & Sons Ltd, 2024.","DOI":"10.1002\/9781119715672.ch18"},{"key":"2025090409340737000_25.4.303.35","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.amjmed.2014.09.030","article-title":"Hypercalcemic crisis: a clinical review","volume":"128","author":"Ahmad","year":"2015","journal-title":"Am J Med"},{"key":"2025090409340737000_25.4.303.36","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"The Lancet"},{"key":"2025090409340737000_25.4.303.37","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/B978-0-7020-4087-0.00049-8","article-title":"Neurologic disorders of mineral metabolism and parathyroid disease","volume":"120","author":"Agrawal","year":"2014","journal-title":"Handb Clin Neurol"},{"key":"2025090409340737000_25.4.303.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0953-6205(03)00098-0"},{"key":"2025090409340737000_25.4.303.39","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200001000-00001"},{"key":"2025090409340737000_25.4.303.40","article-title":"Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia","volume":"7","author":"Ahmed","year":"2019","journal-title":"Med Sci (Basel)"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2023-003801","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:34:20Z","timestamp":1757003660000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2023-003801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,15]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,14]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/pn-2023-003801"],"URL":"https:\/\/doi.org\/10.1136\/pn-2023-003801","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,15]]}}}