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Case Reports
. 2021 Jan 18;14(1):e237740.
doi: 10.1136/bcr-2020-237740.

Cerebral salt-wasting syndrome in a patient with status epilepticus: a rare association

Sudheer Tale  1 , Mrudula Kolli  2 , Kesari Masaipeta  3 , Gautam Vinay Kumar Budumuri  4
Affiliations
Case Reports

Cerebral salt-wasting syndrome in a patient with status epilepticus: a rare association

Sudheer Tale et al. BMJ Case Rep. .

Abstract

Hyponatraemia is one of the most common and serious electrolyte abnormalities in patients with neurological diseases. Assessing the intravascular fluid status, urine sodium, urine and serum osmolality helps to narrow down the differential diagnosis. Differentiation between cerebral salt-wasting syndrome (CSWS), diabetes insipidus and syndrome of inappropriate antidiuretic hormone (SIADH) secretion is absolutely necessary for correct management of hyponatraemia in this group of patients. In this case report, we have presented a 46-year-old gentleman who was admitted to intensive care unit (ICU) with status epilepticus and developed hyponatraemia during course of his ICU stay, diagnosed as CSWS and managed with normal saline and fludrocortisone. His serum sodium gradually improved, consciousness was regained and later shifted to general ward on antiepileptic treatment.

Keywords: adult intensive care; epilepsy and seizures.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Depicting normal contrast-enhanced MRI of the brain.
Figure 2
Figure 2
Electroencephalogram showing spike and wave discharge of 3 Hz in all leads sign of generalised epileptiform discharges.
See this image and copyright information in PMC

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