Hyponatremia and seizures after bowel preparation : Report of three cases

• Published in: Diseases of the colon & rectum Vol. 48; no. 2; pp. 393 - 396
• Main Authors: FRIZELLE, F. A, COLLS, B. M
• Format: Journal Article
• Language: English
• Published: Secaucus, NJ Springer 01.02.2005; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Administration, Oral; Adult; Aged; Biological and medical sciences; Cathartics - administration & dosage; Cathartics - adverse effects; Citric Acid - administration & dosage; Citric Acid - adverse effects; Colonoscopy; Digestive system. Abdomen; Endoscopy; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hyponatremia - chemically induced; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Organometallic Compounds - administration & dosage; Organometallic Compounds - adverse effects; Phosphates - administration & dosage; Phosphates - adverse effects; Seizures - chemically induced; Solutions; Nervous system diseases; Hydroelectrolytic balance disorder; Hyponatremia; Epilepsy; Laxative; Bowel preparations; Inorganic element; Sodium picosulfate; Colonoscopy preparations; Cerebral disorder; Case study; Metabolic disorder; Sodium phosphate; Colonoscopy; Central nervous system disease; Seizure; Endoscopy; Sodium picosulfates
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/s10350-004-0778-6

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.