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zzyzx zzyzx (Member)

hyponatremic seizure

Emergency   (310 Views 6 Comments)
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Has anyone ever seen a hyponatremic seizure in the ER? 

I'm just curious on how the patient presented, how long the seizure lasted, if you saw immediate relief from treatments, etc. details.

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Hello zzyzx -

Did you have an experience with this?

Presentations I've seen have been seizing or post-ictal.  Numerous other patients who are found to have significant or critical hyponatremia it's something that might crop up with a variety of underlying conditions.

Re: Immediate relief - - Do you mean stopping the seizure? Yes normally. Max out benzos if necessary (ativan, valium, versed, etc)., others-  phos/phenytoin...propofol...keppra...

Are you talking about status epilepticus?

 

 

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Yes, several times.

It looks like a seizure. You treat with hypertonic saline, but if you give too much you can cause demyelination.

Often these patients get a bandaid fix by a benzo or other classic antiseizure med, but this neither corrects the problem nor is the most appropriate treatment. That being said upon initial presentation we often will not know their etiology and we aren't going to give 4% saline to every seizure we see.

Good luck on your homework assignment.

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I've never worked where the benzo or any other med used for seizure activity was given to fix the underlying problem of hyponatremia...

 

Edited by JKL33

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2 hours ago, JKL33 said:

I've never worked where the benzo or any other med used for seizure activity was given to fix the underlying problem of hyponatremia...

 

It doesn't, but if a patient comes in seizing and we don't know why, we aren't going to get saline. We wouldn't know that they are hyponatremic until we have their lytes back.

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Ah, yes. Gotcha.

For sure not 4% (at that juncture)....

Edited by JKL33

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