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Case Report Open Access
A previously well 8 yr (wt: 24 kg) child presented with seizures. He had history of loose motions 4-5 episodes & infusion of excess of isolyte p by a quack. The child had confusion, reduced consciousness and seizures but without a significant history of epilepsy, fever & head injury. His serum sodium was noted to be low at 117 mmol/litre. He needed anti-convulsants with subsequent intubation to stop the fitting and was commenced on a hypertonic saline infusion with frequent monitoring of serum sodium. After 10 days patient discharged from hospital with full recovery. Disturbances in sodium concentration are common in the critically ill patient and associated with increased mortality. Correction of hypernatraemia/hypertonicity is critical, but should not exceed 12 mmol/l/day in order to reduce the risk of rebounding brain oedema.There is a risk of long-term neurological damage from central pontine myelinolysis if the hyponatraemia is corrected too rapidly. He went on to make a full recovery without any long-term neurological complications.
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Author(s): Rahul Saini, Sunaina