Q: Rapid correction of Sodium particularly in chronic hyponatremia can be dangerous as it may cause osmotic demyelination commonly known as Central Pontine Myelinolysis (CPM), which is typically irreversible. What are the main risk factors for development of CPM?

Answer: 

• Associated hypokalemia,
• female gender,
• history of alcoholism,
• history of liver transplant  

Reference:  Murase T, Sugimura Y, Takefuji S, et al. Mechanisms and therapy of osmotic demyelination. Am J Med. Jul 2006;119(7 Suppl 1):S69-73.