What is the target serum sodium when treating hyponatremia with neurologic symptoms?

• A. 120 mEq/L
• B. 130 mEq/L
• C. 135 mEq/L
• D. 140 mEq/L

Answer: (A)

In hyponatremia with neurologic symptoms, the priority is to reverse cerebral edema quickly but with careful control of how fast the sodium rises. The goal is to raise the serum sodium by about 4-6 mEq/L in the first 6 hours using hypertonic saline, then continue a cautious correction up to about 8-12 mEq/L in the first 24 hours, avoiding rapid overcorrection to prevent osmotic demyelination.

A practical target after initial correction is typically around 125-130 mEq/L. Among the given options, aiming for about 130 mEq/L fits the recommended approach. Reaching only 120 mEq/L would often be insufficient to relieve symptoms promptly, while 135 or 140 mEq/L would risk overcorrection if the starting level was far below normal. The emphasis is on a controlled rise to relieve symptoms without overshooting.