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Reversible stroke-like symptoms with severe hyponatremia
Lindsey N Holloman1, Victor O Kolade, Daniel R Zapko
1Department of Medicine, University of Tennessee College of Medicine, Chattanooga, USA.
Tennessee Medicine : Journal of the Tennessee Medical Association
|March 20, 2013
Summary
Severe hyponatremia (low sodium levels) can mimic stroke symptoms. This case highlights how correcting sodium levels can reverse these neurological deficits.
Area of Science:
- Neurology
- Endocrinology
- Internal Medicine
Background:
- Hyponatremia, a condition of abnormally low sodium levels in the blood, can present with diverse neurological symptoms.
- Certain medications, including diuretics like hydrochlorothiazide, are known risk factors for developing hyponatremia.
Observation:
- A 65-year-old female presented with acute neurological deficits including generalized weakness, slurred speech, and facial droop, initially concerning for a cerebrovascular event.
- Brain imaging was unremarkable, but laboratory tests revealed severe hyponatremia with a serum sodium level of 99 mmol/L.
Findings:
- The patient's neurological symptoms, including confusion, lethargy, and facial droop, significantly improved with slow correction of her sodium levels.
- Resolution of stroke-like symptoms following sodium repletion strongly suggests hyponatremia as the underlying cause.
Implications:
- This case underscores the importance of considering and evaluating for electrolyte abnormalities, particularly severe hyponatremia, in patients presenting with acute neurological symptoms.
- Prompt diagnosis and management of hyponatremia are crucial for reversing potentially life-threatening neurological manifestations and preventing misdiagnosis of conditions like stroke.
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