Endocrine Abstracts

The problem of the influence of disturbances of Hyper- or Hyponatraemia is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. Electrolyte disbalance affected on the formation of mental disorders, their structure and dynamics in the literature has not been sufficiently studied. Perhaps there are certain factors and patterns of the influence of hypo- and hypernatraemia on mental activity with various lesions of the brain, which requires study.

Purpose: To study the effect serum sodium concentration on the structure and dynamics of mental disorders on the model of a benign tumor of craniopharyngioma.

Material and methods: 89 patients (18–65 years old, mean age 38±2, 44 men and 45 women) were examined after removal of craniopharyngiomas in the early postoperative period. Methods: psychopathological, data from endocrinological, neurological, neuroimaging methods of research were used. Serum sodium concentration was determined in the norm of 135–145 mmol/l.

Results: 1 group – 43 patients (48%) with hypernatraemia after removal: endo-suprasellar (10%), suprasellar (35%), extra-intraventricular (45%) and intraventricular (10%) craniopharyngiomas. Group 2 – 46 patients (52%) with normal serum sodium concentration after removal: endo-suprasellar (39%), suprasellar (37%), extra-intraventricular (11%) and intraventricular (13%) craniopharyngiomas. Analysis of mental disorders in patients revealed productive symptoms in 80%: motor excitement, affective disorders, delirium, visual hallucinations, amnestic confusion. These disorders occurred in patients with hypernatraemia more often (P<0.001) (group 1) than in patients with normal serum sodium concentration (group 2). In the first group there was a subgroup of patients with persistent long hypernatraemia (lasting more than 5–7 days) in 22 patients (51%). In this subgroup there were negative (deficient) symptoms: Korsakov’s syndrome, apathy, increased drowsiness in 15 patients (68%). It was significantly more frequent (P<0.001) compared to patients with normal serum sodium concentration.

Conclusion: Serum sodium concentration affects a person’s mental activity. Hypernatraemia can be a factor that causes productive symptoms and syndromes of mental disorders and adversely affects their dynamics, that it was revealed in patients after removal of craniopharyngiomas.