European Journal of Molecular & Clinical Medicine

Abstract

Hyponatremia is the most common, electrolyte abnormality out of all in critically ill neurological patients. TBM is a common cause of sub-acute and chronic meningitis in developing countries like India. It is an important cause of stroke in young individuals in India. Hyponatremia in TBM is multifactorial and may be due to anorexia, nausea, vomiting, poor intake of sodium, diarrhoea, drugs and associated comorbidities.
Method: This study was a six-month cross-sectional study of consenting patients admitted with a diagnosis of TBM at our hospital. Patients were labelled as having hyponatremia, SIADH and CSWS as per operational definitions. The findings were noted in the Performa along with other demographic Patients were classified as per BMRC stage I/II/III and duration of symptoms.
Results: A total of 135 patients were admitted with the diagnosis of Tubercular Meningitis. Out of 135 patients with TBM, 48.88% (n=66) had hyponatremia. It was found that 13.33% (n=29) had SIADH and 19.26% (n=37) had CSWS. The age range of the patients was from 22 years to 60 years with mean age of 43.78±2.64. There were 61.48% (n=83) male and 38.51% (n=52) were female. Maximum number of patients were in age group 51 – 60 years with 31.19% (n=42). The most common presenting complaint of the patients was fever followed by headache, vomiting, and altered sensorium. It is observed that occurrence of hyponatremia was not dependent on age group (p-value=0.47), gender (p-value=0.106) and Grade of disease (p-value=0.188).
CONCLUSION: Electrolyte disturbance adds to morbidity and mortality in TBM patients. It is thus important to investigate serum electrolytes early in such patients and to differentiate the cause of hyponatremia., so that electrolyte imbalance can be detected early and proper management can be initiated to prevent morbidity and mortality due to electrolyte imbalance.