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Seizures Caused by Water-Electrolyte Imbalance and Epilepsy: Diagnosis and Therapy Problems

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Water-electrolyte homeostasis disorders (WEHD) are considered in two aspects: as a possible factor for inducing acute symptomatic seizures in WEHD patients and as a factor of disorder destabilizing in epilepsy patients. Etiological systematization of WEHD is presented. The fea- tures of brain injury, neurological disorders, and long-term prognosis in patients with acute hyponatremia are discussed. The diagnosis and therapy problems in patients with water-electrolyte homeostasis disorders are analyzed; a clinical case is reported. 

About the Authors

I. G. Rudakova
M.F. Vladimirskiy Moscow Regional Clinical Research Institute, Moscow
Russian Federation

Yu. A. Belova
M.F. Vladimirskiy Moscow Regional Clinical Research Institute, Moscow
Russian Federation

N. V. Kel’
M.F. Vladimirskiy Moscow Regional Clinical Research Institute, Moscow
Russian Federation

M. V. Alakova
M.F. Vladimirskiy Moscow Regional Clinical Research Institute, Moscow
Russian Federation


1. Garcia-Alvarez M, Nordli DR, De Vivo DC. Inherited metabolic disorders. In: Engel J, Pedley TA, editors. Epilepsy: a Comprehensive Textbook. Philadelphia: Lippincott–Raven; 1998. P. 2547–62.

2. Schachter SC, Lopez MR. Metabolic disorders. In: Ettinger AB, Devinsky O, editors. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002. P. 195–208.

3. Gilmore RL. Seizures associated with non-neu- rologic medical conditions. In: Wyllie E, editor. The Treatment of Epilepsy: Principles and Practice. Baltimore: Williams&Wilkins; 1996;1(3):654–65.

4. Wijdicks EF, Sharbrough FW. New-onset seizures in critically ill patients. Neurology. 1993;43(5):1042–4. DOI:

5. Калинин АП, Котов СВ, Рудакова ИГ. Нев- рологические расстройства при эндокринных заболеваниях: Руководство для врачей. 2-е изд. Москва: Медицинское информационное агент- ство; 2009. P. 358–406. [Kalinin AP, Kotov SV, Rudakova IG. Nevrologicheskie rasstroistva pri endokrinnykh zabolevaniyakh: Rukovodstvo dlya vrachei. 2st ed. Moscow: Meditsinskoe informat- sionnoe agentstvo; 2009. P. 358–406.]

6. Arieff AI. Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in healthy women. N Engl J Med. 1986;314(24):1529–35. DOI: 7. Riggs JE. Neurologic manifestations of fluid and electrolyte disturbances. Neurol Clin. 1989;7(3):509–23.

7. Daggett P, Deanfield J, Moss F. Neurological aspects of hyponatraemia. Postgrad Med J. 1982;58(686):737–40. DOI:

8. Hojer J. Management of symptomatic hypona- traemia: dependence on the duration of develop- ment. J Intern Med. 1994;235(5):497–501. DOI: 2796.1994.tb01110.x.

9. Robertson GL, Shelton RL, Athar S. The osmoregulation of vasopressin. Kidney Int. 1976;10(1):25–37. DOI:

10. Siegel AJ, Baldessarini RJ, Klepser MB, McDonald JC. Primary and drug-induced disor- ders of water homeostasis in psychiatric patients: principles of diagnosis and management. Harv Rev Psychiatry. 1998;6(4):190–200. DOI:

11. Gowrishankar M, Lin SH, Mallie JP, et al. Acute hyponatremia in the perioperative period: insights into its pathophysiology and recommenda- tions for management. Clin Nephrol. 1998;50(6):352–60.

12. Kokko JP. Fluids and Electrolytes. In: Goldman L, Bennett JC, editors. Cecil Textbook of Medicine

13. (21st ed). Philadelphia: Saunders; 2000. P. 540–67. 14. Maesaka JK. An expanded view of SIADH, hyponatremia, and hypouricemia. Clin Nephrol. 1996;46(2):79–83.

14. Castilla-Guerra L, Del Carmen Fernandez- Moreno M, Lopez-Chozas JM, Fernandez- Bolanos R. Electrolytes disturbances and seizures. Epilepsia. 2006;47(12):1990–8. DOI: 1167.2006.00861.x.

15. Стаховская ЛВ, Ерохина ЛГ, Лескова НН, Губский ЛВ. Центральный понтинный и экст- рапонтинный миелинолиз. Журнал неврологии и психиатрии им. С.А. Корсакова. 2000;(2):55–8. [Stakhovskaya LV, Erokhina LG, Leskova NN, Gubskii LV. Tsentral'nyi pontinnyi i ekstrapontinnyimielinoliz. Zhurnal nevrologii i psikhiatrii im. S.A. Korsakova. 2000;(2):55–8.] 17. Hadfield MG, Kubal WS. Extrapontine myeli- nolysis of the basal ganglia without central pontine myelinolysis. Clin Neuropathol. 1996;15(2):96–100.

16. Norenberg MD. A hypothesis of osmotic endothelial injury. A pathogenetic mechanism in central pontinemyelinolysis. Arch Neurol. 1983;40(2):66–9. DOI: neur.1983.04050020028004.

17. Farrar HC, Chande VT, Fitzpatrick DF,

18. Shema SJ. Hyponatremia as the cause of seizures in infants: a retrospective analysis of incidence, severi- ty, and clinical predictors. Ann Emerg Med. 1995;26(1):42–8. DOI: 20. Esforzado N, Poch E, Cases A, et al. Central pontine myelinolysis secondary to frequent and rapid shifts in plasma glucose in a diabetic haemodialysis patient. Nephrol Dial Transplant. 1993;8(7):644–6.

19. Hitosni S, Terao Y, Mizuno T, et al. A case of portal-systemic encephalopathy presenting charac- teristic MR images in globus pallidus, hypothala- mus, corpus callosum, pontine base, and middle cerebellar peduncle. Rinsho Shinkeigaku. 1992;32(2):217–9.

20. Tanncan RS, Henry A, Rouhart F, et al. High incidence of neurologic complications following rapid correction of severe hyponatremia in poly- dipsic patients. J Clin Psichiatry. 1994;55(8):349–54.

For citation:

Rudakova I.G., Belova Y.A., Kel’ N.V., Alakova M.V. Seizures Caused by Water-Electrolyte Imbalance and Epilepsy: Diagnosis and Therapy Problems. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(1S):45-47. (In Russ.)

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