Hypernatremia and chorea. A report of two cases

Area of Science:

• Neurology
• Nephrology
• Internal Medicine

Background:

• Hypernatremia, an electrolyte imbalance characterized by elevated serum sodium levels, can arise from dehydration.
• Neurological manifestations of hypernatremia are diverse but typically include lethargy, confusion, and seizures.
• Chorea and myoclonus are movement disorders rarely associated with hypernatremia, particularly in adult populations.

Observation:

• Two adult patients presented with acute onset of generalized chorea and symmetrical myoclonic jerks.
• Both patients had documented hypernatremia secondary to dehydration.
• The neurological symptoms were transient, resolving with correction of the hypernatremia.

Findings:

• This case series describes a rare association between hypernatremia and chorea in adults.
• The observed movement disorders (chorea and myoclonus) suggest a potential impact of severe dehydration and electrolyte disturbance on basal ganglia function.
• The transient nature of symptoms implies a reversible pathophysiological mechanism.

Implications:

• Highlights the importance of considering hypernatremia in the differential diagnosis of new-onset chorea and myoclonus in adults.
• Suggests a potential link between severe dehydration, electrolyte disturbances, and specific movement disorders.
• Further research is warranted to elucidate the precise pathophysiological mechanisms underlying hypernatremia-induced chorea and myoclonus.