Today, Dr. Poi asked:

" So youjiang, why must we correct sodium levels at around 8-10mmol/L a day?"

So i replied:

"i dunno. like seriously i dunno."

I looked at the House Officer.

He looked at me. I knew we made a connection when he gave me the "oh shit look away i dont know either" look.

Ladies and gents, the correct answer is:

CENTRAL PONTINE MYELINOLYSIS!

this is classically observed in alcoholics

alcoholics often have hyponatremia

overvigorous correction results in CPM

note: damage to myelin sheath happening in pons and beyond = ODS osmotic demyelination syndrome

Cranial nerve lesions with quadraparesis

(acute paralysis, dysarthria, dysphagia)

KIV locked in syndrome (ventral pontine syndrome)