Espay · Handbook of clinical neurology 2014 · narrative review · n=?

Neurologic complications of electrolyte disturbances and acid-base balance.

Cited 66 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and textbook chapter without systematic review methodology or original data

PubMed 24365306 · doi:10.1016/B978-0-7020-4086-3.00023-0 · record verified 2026-08-26

What was done

This review chapter synthesized the pathophysiology, diagnostic evaluations, clinical phenotypes, and management strategies for neurological disorders resulting from imbalances in sodium, potassium, calcium, magnesium, phosphorus, and acid-base status (acidemia and alkalemia).

What was found

The abstract is descriptive and reports no numerical findings. It identifies distinct clinical patterns: peripheral nervous system involvement manifesting as areflexic weakness (hypermagnesemia, hyperkalemia, hypophosphatemia); central nervous system involvement presenting as epileptic encephalopathies (hypomagnesemia, dysnatremias, hypocalcemia); and mixed features combining encephalopathy with weakness or paresthesias (hypocalcemia, alkalosis). It also highlights hazards from untreated derangements (such as quadriplegia in hypermagnesemia or visual loss from intracranial hypertension in acidosis) and from overly rapid correction (such as central pontine myelinolysis during hyponatremia correction or arrhythmias during potassium correction).

Why it matters

Electrolyte and acid-base derangements frequently present with severe neurological dysfunction. Prompt syndromic recognition is necessary to correct the underlying cause while avoiding catastrophic iatrogenic damage from inappropriate correction rates.

Limits

This publication is a narrative review chapter rather than an empirical trial or systematic review. The abstract provides no primary human data, quantitative estimates, sample sizes, or comparative outcome measures.

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