A 70-year-old female presents with severe hyponatremia (serum sodium 108 mEq/L) due to SIADH. She is confused and has had a seizure. What is the maximum recommended rate of increase in serum sodium over the first 24 hours to prevent osmotic demyelination syndrome?

✓ Correct Answer: Option B

To prevent osmotic demyelination syndrome, the serum sodium concentration should generally not be increased by more than 6-8 mEq/L in any 24-hour period, and certainly no more than 10-12 mEq/L in the first 24 hours, especially in chronic hyponatremia.