DÄ internationalArchive10/2021Status Epilepticus After Drinking Reverse Osmosis-Treated Water

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Status Epilepticus After Drinking Reverse Osmosis-Treated Water

Dtsch Arztebl Int 2021; 118: 180. DOI: 10.3238/arztebl.m2021.0093

Huber, M; Gillmann, H; Abu-Fares, O

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A 50-year-old female patient complained of malaise while preparing for a colonoscopy, shortly after which she suffered a status epilepticus (tonic-clonic, unrhythmic, chorea-like arm movements, conjugate eye deviation in a caudal direction). Cranial magnetic resonance imaging revealed extensive, partially cortical signal enhancement on T2 FLAIR images with marked cerebral edema, as in hypoxia, for example. Laboratory tests revealed severe hyponatremia (116 mmol/L). EEG initially indicated synchronous bilateral theta rhythm consistent with increased cerebral excitability, whereupon treatment with valproate (1800 mg/day) was undertaken. More details of the patient history emerged in the further course: The fluid intake recommended alongside intestinal cleansing had been performed with several liters of reverse osmosis-treated water, which, as a result of filtering processes and passing through an osmotic membrane during production, has a particularly low mineral content and is used, among other things, in “detoxification” diets. Drinking this type of water is contrary to the specialist and patient information leaflet for this laxative product, which advises against drinking only clear or demineralized water. Following prompt correction of hyponatremia, the EEG and clinical picture normalized, such that a full recovery of (also cognitive) performance to previous levels was achieved.

Axial T2 FLAIR sequence on imaging: a) marked cerebral edema with narrowing of the frontoparietal sulci accompanied by cortical signal enhancement; b) 7 days following admission: reduced cerebral edema and normalization of the cortical signal.
Figure
Axial T2 FLAIR sequence on imaging: a) marked cerebral edema with narrowing of the frontoparietal sulci accompanied by cortical signal enhancement; b) 7 days following admission: reduced cerebral edema and normalization of the cortical signal.

Dr. med. Meret Huber, Klinik für Neurologie, Medizinische Hochschule Hannover, huber.meret@mh-hannover.de

Dr. med. Hans-Jörg Gillmann, Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover

Omar Abu-Fares, Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover

Conflict of interest statement: The authors declare that no conflict of interests exists.

Translated from the original German by Christine Rye.

Cite this as: Huber M, Abu-Fares O, Gillmann HJ: Status epilepticus after drinking reverse osmosis-treated water.
Dtsch Arztebl Int 2021; 118: 180. DOI: 10.3238/arztebl.m2021.0093

Axial T2 FLAIR sequence on imaging: a) marked cerebral edema with narrowing of the frontoparietal sulci accompanied by cortical signal enhancement; b) 7 days following admission: reduced cerebral edema and normalization of the cortical signal.
Figure
Axial T2 FLAIR sequence on imaging: a) marked cerebral edema with narrowing of the frontoparietal sulci accompanied by cortical signal enhancement; b) 7 days following admission: reduced cerebral edema and normalization of the cortical signal.