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April 18, 1966

Irreversible Brain Damage After Water Intoxication

Author Affiliations

From the Department of Medicine, University of Arkansas Medical Center, Little Rock.

JAMA. 1966;196(3):286-288. doi:10.1001/jama.1966.03100160136045

WATER intoxication is the term that Rowntree1 applied to the syndrome resulting from extreme hypotonicity of body fluids. Since his description of this disorder in 1923, cases have been described in varied clinical settings. Although fatal cases have been reported, the impression conveyed by the literature on on this subject is that the prognosis is good with correction of hypotonicity. Cooke2 states that permanent damage to the brain may occur as a sequela of water intoxication, but does not document this assertion. Certainly most case reports and reviews imply that the abnormal neurological state is completely reversible. It is the purpose of this paper to present two cases of water intoxication followed by permanent brain damage.

Report of Cases 

Case 1.—  In October 1964, this 78-year-old woman had acute diverticulitis with intestinal obstruction, and a colostomy was performed. At that time the blood urea nitrogen (BUN) level was