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Hyponatremic seizure following ECT.

A J Finlayson¹, W V Vieweg, W D Wilkey

¹University of Western Ontario, Woodstock.

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie

|June 1, 1989

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A woman experienced a seizure due to severe hyponatremia from drinking too much water. Psychotropic drugs may have also lowered her seizure threshold, complicating the diagnosis.

Area of Science:

Neurology
Endocrinology
Psychiatry

Background:

A 55-year-old woman undergoing treatment for depression with medication and electroconvulsive therapy (ECT) presented with a spontaneous seizure.
Investigated the potential causes of a grand mal seizure in a patient with a history of depression and concurrent medical treatments.

Observation:

The patient experienced a grand mal seizure, a severe type of epileptic fit.
The seizure was spontaneous and occurred in the context of psychiatric treatment.

Findings:

The primary cause of the seizure was identified as severe hyponatremia (low sodium levels).
Hyponatremia resulted from self-induced water intoxication.
Psychotropic medications used for depression may have contributed by lowering the seizure threshold.

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Implications:

Highlights the critical importance of electrolyte balance, particularly sodium levels, in preventing seizures.
Underscores the potential for iatrogenic causes of seizures in patients undergoing psychiatric treatment.
Emphasizes the need for careful consideration of medication side effects and fluid balance in managing patients with depression.