Hyperacute hyponatremia mimicking acute ischemic stroke: A case report.
Publication/Presentation Date
7-10-2021
Abstract
We present a case of hyperacute hyponatremia with stroke like symptoms on presentation. Symptoms included confusion, left-sided facial droop, right-sided hemiparesis, dysarthria and aphasia, with an NIH stroke score of 5. Sodium level at the time of presentation was 119 mmol/L which dropped acutely from 138 mmol/L seven hours prior. Symptoms improved after treatment with 3% saline and no evidence of stroke, intracranial hemorrhage or space-occupying lesion was seen on imaging. The most likely cause of the hyponatremia was increased free water consumption and ADH surge. The patient remained symptom free after discharge with resolution of hyponatremia. Acute hyponatremia can cause focal neurological complaints and deficits, mimicking acute ischemic stroke. We advise clinicians to be aware of this entity when considering interventions for possible acute ischemic stroke and evaluating a patient with focal neurological deficits.
ISSN
1532-8171
Published In/Presented At
Balbi, A., Sadowski, J. A., Torrens, D., Jacoby, J. L., Yacoub, H. A., & Eygnor, J. K. (2021). Hyperacute hyponatremia mimicking acute ischemic stroke: A case report. The American Journal of Emergency Medicine, S0735-6757(21)00568-4. Advance online publication. https://doi.org/10.1016/j.ajem.2021.07.017
Disciplines
Emergency Medicine
PubMedID
34304920
Department(s)
Department of Emergency Medicine
Document Type
Article