[Disorders of consciousness due to disorders of body fluid composition--case report of a female patient].

Lijec Vjesn

Zavod za hitnu i intenzivu medicinu, Klinika za unutarnje bolesti, Medicinskog fakulteta Sveucilista u Zagrebu i Klinickog bolnickog centra Rebro.

Published: June 1995

We report a female patient presenting with sepsis and multi-organ failure following eclampsia and intrauterine childdeath. In the phase of recovery, the patient developed consciousness disorder and coma characterized by fasciculation, generalized myoclonia and respiratory insufficiency. The clinical picture corresponded to that of Lance Adam's syndrome. A quick change in the composition of body fluids in the polyuric phase of renal insufficiency associated with an antidiuretic hormone deficit was a cause of that disorder. Metabolic dysfunction and hyperexcitability of neurons developed as a result. Hyperexcitability of the caudal part of the medulla oblongata was responsible for the development of myoclonia. Following the correction of that disorder, the patient completely improved.

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