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Hyponatremia and seizures presenting in the first two years of life
Insights
Infant water intoxication, a form of hyponatremia, can cause seizures in children under two. Avoiding excessive water intake is crucial for preventing this condition and its neurological complications.
Area of Science:
- Pediatrics
- Neurology
- Endocrinology
Background:
- Hyponatremia (low serum sodium) is a common electrolyte imbalance in infants.
- Seizures are a significant concern in pediatric neurology, with various underlying causes.
Purpose of the Study:
- To investigate the incidence and causes of hyponatremia in young children.
- To determine the association between hyponatremia and seizures in infants.
- To highlight the role of infant water intoxication in pediatric seizures.
Main Methods:
- Retrospective chart review of 15 patients under two years old with serum sodium < 127 mEq/L over three months.
- Analysis of seizure presentation and correlation with hyponatremia.
- Review of diagnoses including cystic fibrosis and water intoxication.
Main Results:
- 15 infants presented with hyponatremia.
- Seven patients (47%) experienced seizures.
- Hyponatremia was the cause of 58% of afebrile seizures in this age group.
- Four of eight non-seizing patients had cystic fibrosis.
- Most seizing patients likely had infant water intoxication.
Conclusions:
- Hyponatremia, particularly from infant water intoxication, may be an under-recognized cause of seizures in early childhood.
- Physicians and caregivers should be aware of dietary practices that can lead to water intoxication.
- Early recognition and management of hyponatremic seizures are essential.
Abstract:
During a three-month period, 15 patients under two years of age presented with serum sodium concentrations less than 127 mEq/L. Seven (47%) of these patients presented with seizures. Hyponatremia accounted for a majority (58%) of the afebrile seizures in children under two years during this period. Of the eight patients without seizures, four later proved to have cystic fibrosis. Most of the patients with seizures appear to represent the syndrome of infant water intoxication. Hyponatremia may account for more seizures in early life than has been appreciated. Physicians and parents should avoid dietary practices which promote water intoxication. The etiology, diagnosis, and management of water intoxication and hyponatremic seizures are discussed.