Hyponatremia and seizures after bowel preparation: report of three cases.
Oral sodium phosphate and sodium picosulfates/magnesium citrate are commonly used to evacuate the colon and rectum before colonoscopy or colorectal surgery. These substances, however, are known to cause electrolyte abnormalities. Seizures caused by electrolyte abnormalities associated with bowel preparation have only rarely been reported. We report the cases of three patients with no prior history of seizures, who had their first seizure associated with hyponatremia following ingestion of sodium phosphate or sodium picosulfates/magnesium citrate combination. Care must be taken with patients with a low seizure threshold and those with possible chronic sodium depletion, such as patients on thiazide diuretics, who are undertaking bowel preparation with oral sodium phosphate or sodium picosulfates/magnesium citrate combination.
Frizelle
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FA
Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand. frank.frizelle@chmeds.ac.nz
Colls
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BM
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D010710:Phosphates / Q000008:administration & dosage / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced*; D012996:Solutions
D002400:Cathartics; D009942:Organometallic Compounds; D010710:Phosphates; D012996:Solutions; D019343:Citric Acid; C110422:magnesium citrate; C018279:sodium phosphate