As pressure increases in the skull, herniation of the brain can occur, which is a squeezing of the brain across the internal structures of the skull. This can lead to headache, nausea, vomiting, confusion, seizures, brain stem compression and respiratory arrest, and non-cardiogenic accumulation of fluid in the lungs. This is usually fatal if not immediately treated. Symptom severity depends on how fast and how severe the drop in blood sodium level is. A gradual drop, even to very low levels, may be tolerated well if it occurs over several days or weeks, because of neuronal adaptation. The presence of underlying neurological disease such as a seizure disorder or non-neurological metabolic abnormalities, also affects the severity of neurologic symptoms. Chronic hyponatremia can lead to such complications as neurological impairments. These neurological impairments most often affect gait (walking) and attention, and can lead to increased reaction time and falls. Hyponatremia, by interfering with bone metabolism, has been linked with a doubled risk of osteoporosis and an increased risk of bone fracture. Causes
The specific causes of hyponatremia are generally divided into those with low tonicity (lower than normal concentration of solutes), without low tonicity, and falsely low sodiums. Those with low tonicity are then grouped by whether the person has high fluid volume, normal fluid volume, or low fluid volume. Too little sodium in the diet alone is very rarely the cause of hyponatremia. High volume
Both sodium and water content increase: Increase in sodium content leads to hypervolemia and water content to hyponatremia.
Cirrhosis of the liver
Congestive heart failure
Nephrotic syndrome in the kidneys
Excessive drinking of fluids

Normal volume
There is volume expansion in the body, no edema, but hyponatremia occurs
SIADH (and its many causes)
Hypothyroidism
Not enough ACTH
Beer potomania
Normal physiologic change of pregnancy
Reset osmostat

Low volume
Hypovolemia (extracellular volume loss) is due to total body sodium loss. Hyponatremia is caused by a relatively smaller loss in total body water. Any cause of hypovolemia such as prolonged vomiting, decreased oral intake, severe diarrhea
Diuretic use (due to the diuretic causing a volume depleted state and thence ADH release, and not a direct result of diuretic-induced urine sodium loss)
Addisons disease and congenital adrenal hyperplasia in which the adrenal glands do not produce enough steroid hormones (combined glucocorticoid and mineralocorticoid deficiency)
Pancreatitis
Prolonged exercise and sweating, combined with drinking water without electrolytes is the cause of exercise-associated hyponatremia (EAH). It is common in marathon runners and participants of other endurance events. The use of MDMA (ecstasy) can result in hyponatremia. Medication
Antipsychotics have been reported to cause hyponatremia in a review of medical articles from 1946 to 2016.Available evidence suggests that all classes of psychotropics, i.e., antidepressants, antipsychotics, mood stabilizers, and sedative/hypnotics can lead to hyponatremia. Age is a significant factor for drug induced hyponatremia. Other causes
Miscellaneous causes that are not included under the above classification scheme include the following:

False or pseudo hyponatremia is caused by a false lab measurement of sodium due to massive increases in blood triglyceride levels or extreme elevation of immunoglobulins as may occur in multiple myeloma.