Hyponatremic seizure in a child using desmopressin for nocturnal enuresis

Abstract

Background: Intranasal desmopressin has been used extensively to treat primary nocturnal enuresis. While it has proven to be a safe, effective agent for many who are affected by this condition, the potential for complications exists.

Objectives: To report a case of severe hyponatremia associated with a generalized tonic-clonic seizure in a 10-year-old boy who had been receiving intranasal desmopressin nightly for nocturnal enuresis and to briefly review therapeutic options for nocturnal enuresis; and to present the role of desmopressin.

Setting: Georgetown University Medical Center, Washington, DC.

Intervention: Fluid restriction and intravenous isotonic saline solution with 5% dextrose was administered to raise the serum sodium level.

Outcome: Prevention of further seizures with normalization of serum sodium levels without any obvious neurological sequelae.

Conclusions: This case illustrates the importance of weighing the benefits and risks of intranasal desmopressin therapy.