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Previous Volume 352:1613-1614 April 14, 2005 Number 15 Next

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To the Editor: Hyperthermia has long been recognized as a cause of altered mental status after a marathon, but in recent years exercise-associated hyponatremia has become increasingly common.¹ In 2003, there was an unexpected increase in the number of London Marathon runners who presented to St. Thomas' Hospital, situated near the finish line of the race, among them 17 runners with altered mental status (Glasgow Coma Scale scores, 11 to 13). Six of these 17 runners received a diagnosis of hyperthermia (temperature, >37.7°C), and 11 a diagnosis of exercise-associated hyponatremia (serum sodium level, <135 mmol per liter). There were distinct . . . [Full Text of this Article]

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