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Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale

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Hyponatraemia-associated catatonia.

Eimear McGuire¹, Mythily Yohanathan², Leona Lally²

¹Sligo Leitrim Mental Health, St. Columba's Hospital, Sligo, Ireland.

BMJ Case Reports

|July 16, 2017

Summary

Low sodium levels (hyponatremia) can cause severe mental status changes, including catatonia. This case report details two distinct hyponatremia-induced psychotic episodes in one patient, emphasizing the critical role of sodium balance in mental health.

Keywords:

Endocrinology Geriatric Medicine Neurology Psychiatry Psychiatry (drugs And Medicines)

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Area of Science:

Neurology
Psychiatry
Endocrinology

Background:

Hyponatremia, or low sodium levels, is a common electrolyte imbalance.
Electrolyte disturbances can significantly impact neurological and psychiatric function.
Catatonia is a complex psychomotor syndrome with various potential underlying causes.

Observation:

This case report describes a patient experiencing two separate episodes of catatonia.
Both episodes were strongly associated with significantly depleted serum sodium levels (hyponatremia).
The patient exhibited profound psychotic symptoms, including catatonia, during these periods.

Findings:

The patient's catatonic symptoms and psychosis resolved completely upon normalization of serum sodium levels.
This marks the first documented instance of two distinct, temporally unrelated episodes of hyponatremia-induced catatonia in the same individual.
The findings highlight a direct correlation between sodium depletion and the manifestation of severe psychiatric symptoms.

Implications:

This case underscores the critical importance of monitoring electrolyte balance, particularly sodium, in patients presenting with psychiatric disturbances.
It emphasizes that hyponatremia should be considered in the differential diagnosis of catatonia and psychosis.
Further research into the neurobiological mechanisms linking sodium levels and mental status is warranted.