Lee Jung-Ju
Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
J Epilepsy Res. 2022 Dec 30;12(2):82-84. doi: 10.14581/jer.22016. eCollection 2022 Dec.
Cerebral salt wasting syndrome (CSWS) is defined as a renal loss of sodium in cerebral disorders causing hyponatremia and loss of extracellular fluid volume. Similar laboratory findings may be seen in other conditions such as syndrome of inappropriate antidiuretic hormone secretion (SIADH). A 58-year-old male visited our emergency department because of the sudden development of seizures during sleep. Magnetic resonance imaging revealed subtle high signal intensity in the right hippocampus on diffusion-weighted imaging. Ictal rhythmic discharges were observed in the concordant area. Altered metal status, polyuria and laboratory test findings including hyponatremia were compatible with CSWS. After hydration and salt replacement, his mental state and hyponatremia gradually recovered. For diagnosing CSWS, meticulous physical examinations including analysis of fluid balance are essential. CSWS should be considered in patients with hyponatremia and polyuria. Accurate diagnosis of CSWS and SIADH is crucial as the treatment plans for these two conditions are completely different.
脑性盐耗综合征（CSWS）被定义为在脑部疾病中肾脏对钠的丢失，导致低钠血症和细胞外液量减少。在其他情况如抗利尿激素分泌不当综合征（SIADH）中可能会出现类似的实验室检查结果。一名58岁男性因睡眠中突然发作癫痫而就诊于我院急诊科。磁共振成像在弥散加权成像上显示右侧海马区有轻微高信号强度。在相应区域观察到发作期节律性放电。金属状态改变、多尿以及包括低钠血症在内的实验室检查结果与CSWS相符。经过补液和补充盐分后，他的精神状态和低钠血症逐渐恢复。对于诊断CSWS，细致的体格检查包括液体平衡分析至关重要。低钠血症和多尿的患者应考虑CSWS。准确诊断CSWS和SIADH至关重要，因为这两种情况的治疗方案完全不同。
