Treat Christian, Ulloa Nicholas, Kettler Alyssa, Lawrence David
Stony Brook University, Department of Emergency Medicine, Stony Brook, New York.
Clin Pract Cases Emerg Med. 2024 Aug;8(3):239-242. doi: 10.5811/cpcem.6562.
Neurogenic pulmonary edema is a rare and potentially life-threatening condition that can present as severe pulmonary edema after significant neurologic insults. This is the first documented instance that shows a plausible causal link between cannabis consumption, psychogenic polydipsia, and the subsequent development of neurogenic pulmonary edema associated with status epilepticus secondary to acute hyponatremia.
We report a case of a 34-year-old female who presented to the emergency department altered and postictal after a witnessed new-onset seizure. She developed significant respiratory distress that required intubation. Her sodium was 121 millimoles per liter (mmol/L), from 137 mmol/L 36 hours prior on routine outpatient labs. Further history revealed excessive water ingestion after eating a cannabis edible prior to the seizure.
This case highlights the importance of recognizing neurogenic pulmonary edema in connection with psychogenic polydipsia, severe hyponatremia, and status epilepticus subsequent to cannabis consumption.
神经源性肺水肿是一种罕见且可能危及生命的病症，可在严重神经损伤后表现为严重肺水肿。这是首例有记录的病例，显示大麻消费、精神性烦渴与随后因急性低钠血症继发癫痫持续状态而出现的神经源性肺水肿之间存在合理的因果关系。
我们报告一例34岁女性病例，该患者在目睹新发癫痫发作后意识改变且处于发作后状态，被送往急诊科。她出现严重呼吸窘迫，需要插管。她的钠水平为每升121毫摩尔（mmol/L），而36小时前在常规门诊实验室检查时为137 mmol/L。进一步询问病史发现，她在癫痫发作前食用了含大麻的食品后过量饮水。
本病例突出了认识与精神性烦渴、严重低钠血症以及大麻消费后癫痫持续状态相关的神经源性肺水肿的重要性。
