A young man who drank a quart of soy sauce went into a coma and nearly died from an excess of salt in his body, according to a recent case report. The 19-year-old, who drank the soy sauce after being dared by friends, is the first person known to have deliberately overdosed on such a high amount of salt and survived with no lasting neurological problems, according to the doctors in Virginia who reported his case. The case report was published online June 4 in the Journal of Emergency Medicine. Too much salt in the blood, a condition called hypernatremia, is usually seen in people with psychiatric conditions who develop a strong appetite for the condiment, said Dr. David J. Carlberg, who treated the young man and works as an emergency medicine physician at MedStar Georgetown University Hospital in Washington, D.C. Hypernatremia is dangerous because it causes the brain to lose water. When there is too much saltin the bloodstream, water moves out of the body tissues and into the blood by the process of osmosis, to try to equalize the salt concentration between the two. As water the leaves the brain, the organ can shrink and bleed, Carlberg said. After the man drank the soy sauce, he began twitching and having seizures, and the friends took him to an emergency room. That hospital administered anti-seizure medication, and he was already in a coma when he was taken to the hospital where Carlberg was working, the University of Virginia Medical Center, nearly four hours after the event. "He didn't respond to any of the stimuli that we gave him," Carlberg said. "He had some clonus, which is just elevated reflexes. It's a sign that basically the nervous system wasn't working very well."