Hyponatraemia presenting as reversible cerebellar ataxia in Addison's disease

Judah Nijas Arul; Mani Rajkumar; Lakshmanan Suja

doi:10.1136/bcr-2018-227933

Hyponatraemia presenting as reversible cerebellar ataxia in Addison's disease

BMJ Case Rep. 2019 Aug 15;12(8):e227933. doi: 10.1136/bcr-2018-227933.

Authors

Judah Nijas Arul¹, Mani Rajkumar¹, Lakshmanan Suja¹

Affiliation

¹ General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Abstract

Addison's disease is a common endocrinopathy often diagnosed in patients presenting with hyponatraemia. Cerebellar ataxia as a presentation of hyponatraemia is extremely rare. A 42-year-old man presented with vomiting, fever, ataxic gait and scanning type of dysarthria. Clinical examination revealed signs suggestive of isolated cerebellar involvement. Patient was found to have severe hyponatraemia and serum cortisol was found to be extremely low while MRI brain was found to be normal. Corticosteroid therapy was initiated and cerebellar ataxia was resolved following normalisation of sodium levels.

Keywords: adrenal disorders; brain stem/cerebellum.

Publication types

Case Reports

MeSH terms

Addison Disease / complications
Addison Disease / diagnosis*
Adult
Cerebellar Ataxia / complications
Cerebellar Ataxia / diagnosis*
Diagnosis, Differential
Humans
Hyponatremia / diagnosis*
Hyponatremia / etiology
Male