Hyponatremic seizure in a child using desmopressin for nocturnal enuresis.

BACKGROUND Intranasal desmopressin has been used extensively to treat primary nocturnal enuresis. While it has proven to be a safe, effective agent for many who are affected by this condition, the potential for complications exists. OBJECTIVES To report a case of severe hyponatremia associated with a generalized tonic-clonic seizure in a 10-year-old boy who had been receiving intranasal desmopressin nightly for nocturnal enuresis and to briefly review therapeutic options for nocturnal enuresis; and to present the role of desmopressin. SETTING Georgetown University Medical Center, Washington, DC. INTERVENTION Fluid restriction and intravenous isotonic saline solution with 5% dextrose was administered to raise the serum sodium level. OUTCOME Prevention of further seizures with normalization of serum sodium levels without any obvious neurological sequelae. CONCLUSIONS This case illustrates the importance of weighing the benefits and risks of intranasal desmopressin therapy.