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Yeungnam Univ J Med > Volume 32(1); 2015 > Article
Yeungnam University Journal of Medicine 2015;32(1):55-59.
DOI: https://doi.org/10.12701/yujm.2015.32.1.55    Published online June 30, 2015.
Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution.
Jae Young Lee, Byung Ik Jang, Yoon Jeong Nam, Jay Song, Min Cheol Kim, Seung Min Chung, Jong Geol Jang, Jae Ho Cho
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. sjbi@med.yu.ac.kr
Abstract
The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.
Key Words: Polyethylene glycol, Bowel preparation, Hyponatremia, Seizure
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