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What Could Cause A Dementia Or Delirium Like State After Treating Hyponatremia?

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Posted on Wed, 5 Jul 2023
Question: After a 6-day stay in the hospital for Hyponatremia, my mother is now experiencing a very bad dementia like state. An MRI of her brain showed mild signs if early dementia with some volume loss. However, the staff didn"t think this was anything unusual for someone 73 years old. A follow-up with her pcp, prompted a CT scan of her chest, stomach, and pelvis. Nothing was found. She sustained 2 seizures while in the hospital which was attributed to the hyponatremia. She is now on 2 different seizure medications. She had no history of dementia or epilepsy prior to her bout with hyponatremia. The conclusion was made that her bp medicine, Hydrochlorothioaxide, caused the drop in Na. Also at her follow- up, her blood test indicated a slight dip in het Na at 127. She has kidney disease, hypotension, and sarcoidosis; none of which gave her any problems previously. She was very mentally sharp and active. She has a follow-up with a neurologist on 9/21. Could tjhis possibly be delirium? If so, could she recover from this? This is so painful to watch. Thank you.
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
Hyponatremia may justify these issues.

Detailed Answer:

Hello,

The dementia-like state is fully explained by hyponatremia. This is reinforced by the fact that there were no signs of dementia previously. If the symptoms of cognitive impairment started nearly at the same time with hyponatremia, then it is understandable that there is no dementia in causing such issues.

There should be correct control of sodium blood levels in order to improve the cognitive function too.

Hope you found the answer helpful. Let me know if I can assist you further.

Regards,
Dr. Erion Spaho
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Erion Spaho (48 minutes later)
Thank you Dr. Spaho. The one thing yhst still has me baffled is that the behavior continued in the hospital even aftet her sodium was corrected. It had dipped to 127 from 136 in a few days. Is this common? Also, could the seizure medication be keeping contributing to this behavior since dhe has never been epileptic.
doctor
Answered by Dr. Dr. Erion Spaho (10 hours later)
Brief Answer:
Sodium levels should be maintained within normal ranges.

Detailed Answer:

Hi,

Welcome back.

The sodium level is still low, so, it is responsible for the continuation of symptoms. Some fluctuations of sodium levels after hyponatremia may happen, but the aim should be to keep the natremia between normal ranges. Seizure medication also may cause cognitive issues as probable adverse effects.

Hope this helps.

Regards,
Dr. Erion Spaho
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4494 Questions

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What Could Cause A Dementia Or Delirium Like State After Treating Hyponatremia?

Brief Answer: Hyponatremia may justify these issues. Detailed Answer: Hello, The dementia-like state is fully explained by hyponatremia. This is reinforced by the fact that there were no signs of dementia previously. If the symptoms of cognitive impairment started nearly at the same time with hyponatremia, then it is understandable that there is no dementia in causing such issues. There should be correct control of sodium blood levels in order to improve the cognitive function too. Hope you found the answer helpful. Let me know if I can assist you further. Regards, Dr. Erion Spaho