HYPERNATREMIA AND ACUTE NEUROPSYCHIATRIC DISTURBANCES

*Dr. Alisha S. Patil, Dr. Priya Chugh and Dr. Sanjiv S. Kale

ABSTRACT

Disorders in the homeostasis of serum sodium are relatively common in elderly hospitalized patients and if undetected can lead to an array of life-threatening manifestations and pose as a challenge to the management of the patients. Behavioural disturbances, though common with hyponatremia, are rare with increased serum sodium. Hypernatremia often presents with an non specific clinical symptoms and is noticed in the extremes of ages. Severe signs of hypernatremia include lethargy, somnolence and coma all of which pose as a serious threat to the patient. In this case series we present 20 cases, all of whom are patients who presented with behavioural disturbances or psychiatric symptoms later found to be a consequence of increased serum sodium. This case series highlights that an underlying diagnosis of hypernatremia can often be missed for a psychiatric illness due to its rare clinical presentation in some patients.

Keywords: Hypernatremia, irritability, Neuro-Psychiatric manifestations, Behavioural disturbances.