A 57-year-old woman presented with a generalised tonic-clonic seizure.
Pathological history included hypothyroidism, migraine and hypercholesterolemia.
Three days prior to the episode, the patient had been on a liquid diet as preparation for a rectal tenesmus.
On the same day he took two sachets of Citrafleet®, two tablets of bisacodilo 5 mg and abundant water.
Examination revealed temporary disorientation, indifferent right plantar cutaneous reflex, without neck stiffness or other abnormalities.
Analytical results are reflected in natraemia of 120 mEq/l and creatine phosphokinase (CK) levels of 429 IU/l which increased to 30778 IU/l.
A cranial CT scan showed a small chronic infarction without other lesions.
Since the patient presented neurological symptoms, 3 % saline was administered at a rate of 1.5 ml/kg/h, with improvement in serum sodium and resolution of neurological symptoms within 2 hours.
Subsequently contributions were maintained with saline (3).
CK levels continued to rise up to 72 hours despite hydration, with no impact on renal function and improvement in the following days.
