Hyponatremic Encephalopathy Mimicking Hypoxic-Ischemic Encephalopathy

Excerpt

Hyponatremia, defined as serum Na⁺ concentration < less than 130 mEq/l, is one of the most common electrolyte disturbances in hospitalized patients with a wide variety of medical problems [1]. Magnetic resonance imaging (MRI) findings in hypoxic-ischemic encephalopathy are very characteristic: brain swelling, cortical laminar necrosis, signal hyperintensity of basal ganglia at the beginning, followed by white-matter degeneration and, later, by atrophy. The mechanisms of neuronal damage in hypoxic-ischemic encephalopathy are not clearly understood. To the best of our knowledge, similar MRI abnormalities have never been described in patients with hyponatremic encephalopathy without evidence of hypoxia or respiratory failure. We report the case of a schizophrenic patient with psychogenic polydipsia, who suffered from severe hyponatremia without any history of a hypoxic-ischemic event. …