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March 1998

Hyponatremic Seizure in a Child Using Desmopressin for Nocturnal Enuresis

Author Affiliations

From the Department of Pediatrics, Divisions of General Pediatrics (Drs Donoghue and Pillsbury), Pediatric Neurology (Dr Latimer), and Pediatric Critical Care and Pulmonary Medicine (Dr Hertzog), Georgetown University Medical Center, Washington, DC.

Arch Pediatr Adolesc Med. 1998;152(3):290-292. doi:10.1001/archpedi.152.3.290

Background  Intranasal desmopressin has been used extensively to treat primary nocturnal enuresis. While it has proven to be a safe, effective agent for many who are affected by this condition, the potential for complications exists.

Objectives  To report a case of severe hyponatremia associated with a generalized tonic-clonic seizure in a 10-year-old boy who had been receiving intranasal desmopressin nightly for nocturnal enuresis and to briefly review therapeutic options for nocturnal enuresis; and to present the role of desmopressin.

Setting  Georgetown University Medical Center, Washington, DC.

Intervention  Fluid restriction and intravenous isotonic saline solution with 5% dextrose was administered to raise the serum sodium level.

Outcome  Prevention of further seizures with normalization of serum sodium levels without any obvious neurological sequelae.

Conclusions  This case illustrates the importance of weighing the benefits and risks of intranasal desmopressin therapy.