Primary empty sella syndrome presenting as hyponatremia

Empty sella is often an incidental magnetic resonance imaging (MRI) finding. It may be partial or complete and can primary secondary due to intracranial hypertension, radiation exposure pituitary apoplexy. Most of the patients are asymptomatic but features panhypopituitarism develop in some. This a case report 70-year-old female who presented with complaints vomiting, altered sensorium irritability, generalized weakness, difficulty speaking, one episode seizure. Blood investigations revealed hyponatremia that was euvolemic. On further evaluation, she found have decreased cortisol, follicle stimulating hormone, thyroxine, normal prolactin, thyroid-stimulating hormone values suggestive panhypopituitarism. MRI brain showed empty sella. Her serum sodium levels improved after starting glucocoticoids thyroxine tablets, thereby confirming diagnosis In absence any history irradiation, hemorrhage, surgery, syndrome made.