A 4-year-old girl is admitted with four days of diarrhoea. She is 10 per cent dehydrated but not shocked, and…

Question

A 4-year-old girl is admitted with four days of diarrhoea. She is 10 per cent dehydrated but not shocked, and her serum sodium on arrival is 172 mmol/L (135-145). Intravenous rehydration is commenced. Eight hours later the sodium is 148 mmol/L, she has become progressively drowsy, and she then has a generalised tonic-clonic seizure lasting three minutes. Her blood glucose is 5.8 mmol/L, ionised calcium is normal and she is afebrile. Which one of the following best explains her deterioration?

Accepted Answer

Cerebral oedema

Answer

Cerebral venous sinus thrombosis

Answer

Hypocalcaemic tetany

Answer

Hypoglycaemia

Answer

Osmotic demyelination syndrome

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