An animation of the Na/K pump. Potassium deficiency (related to excess aldosterone) is often found in pwms. With potassium deficiency, the pump won't work as well as it should because K is required to keep the pump moving Na out of cells.
http://highered.mcgraw-hill.com/sites/0 ... works.html
A blog with a wonderful explanation of na/k pump failure
http://mscheitlin.blogspot.com/2013/01/ ... nd-ds.html
This is what happens when Na/k pump doesn't work as well as it should.
http://physiologyonline.physiology.org/ ... 4/257.long
Swelling of vascular endothelial cells decreases cerebral perfusion, causing ischemia and infarction. Swelling of the epithelial cells of the choroid plexus and the endothelial cell blood-brain barrier can compromise their structural and functional integrity, thereby altering the permeability of barrier.
http://link.springer.com/chapter/10.100 ... _8?LI=true
Axonal Protection with Sodium Channel Blocking Agents in Models of Multiple Sclerosis
Joel A. Black, Kenneth J. Smith, Stephen G. Waxman
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Axonal degeneration in multiple sclerosis (MS) has come to be increasingly appreciated as a major contributor to nonremitting disability in MS. Significant axonal damage and loss occur with acute MS plaques, and this loss continues, albeit at an attenuated rate, in chronic inactive plaques. These observations have triggered considerable interest in identifying neuroprotective therapies that can ameliorate axonal injury and degeneration in neuroinflammatory disorders. Accumulating evidence implicates participation of voltage-gated sodium channels in Ca2+-mediated damage of central white matter axons. Indeed, blockade of sodium channels has been shown to provide protective effects for axons exposed to anoxia, trauma, and ischemia injuries. In the present chapter, we describe work from our laboratories that has examined the effects of sodium channel blocking agents on disease progression in rodent models of neuroinflammatory lesions, including experimental autoimmune encephalomyelitis (EAE), a disease that is widely utilized to model aspects of MS. The sodium channel blocking agents utilized in our studies—phenytoin, carbamazepine, flecainide, and lamotrigine—provide robust protection of spinal cord axons, preserve action potential conduction, significantly diminish immune cell infiltration, and attenuate neurological deficits in EAE. Results from these studies provided a rationale for planning and implementing clinical studies utilizing sodium channel blocking agents in patients with MS, and several clinical trials examining the efficacy of sodium channel blockade in ameliorating clinical disability in MS are currently ongoing.
I'm not going to bother finding out how na/k imbalance in favor of K causes the lesions in CAH, but I'm willing to bet it's similar to what happens with MS.