Updated 13 April 2015

Answer: What's your diagnosis? – Case 6

In our latest case we met Mr T, a 19 year old engineering student and avid marathon runner, who presented with epilepsy-like fits after a run.


In this week’s case we met Mr T, a young engineering student that presented with rather strange epilepsy-like fits to the emergency room. Read the full case report here.

Disturbance in blood sodium content

Mr T suffered from a classic case of hyponatremia – a condition where the sodium content of the blood is too low. Sodium is important in maintaining the fluid balance of our bodies and also important in nerve function and ensuring our muscles work well.

In mr T’s case, an avid athlete training for a half marathon, excessive running and associated fluid losses may cause a disturbance in the sodium content of his blood. Sweating may lead to significant fluid loss and eventually dehydration which may be one explanation of his condition. Another cause may be that Mr T’s water intake was too much. When sweating, one loses sodium. By taking in large amounts of water, the sodium blood concentration may further decrease.

Hyponatremia typically presents with nausea and vomiting, headaches, muscle spasms, irritability and eventually neurological manifestations suck as confusion and seizures.

In severe, untreated cases hyponatremia can lead to brain swelling which may be fatal.

A doctor will do blood tests to determine if any electrolyte disturbances are present if a patient present with unexplained neurological symptoms and signs. He will then treat the deficits with intravenous fluids containing sodium.

It is important for runners to make sure that they do not over hydrate or not compensate for fluid losses.

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays and we'll post the answer with the story on Mondays, or you can find out via the Daily Tip – sign up here.

Previously on What's Your Diagnosis

What's your diagnosis? – Case 1: vomiting and weight loss

What's your diagnosis? – Case 2: eye pain

What's your diagnosis -  Case 3: strange behaviour and a bullet in the back?

What's your diagnosis - Case 4: seeing odd things

What's your diagnosis - Case 5: mysterious lungs

Image: Runner drinking water from Shutterstock

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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