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Refractory epilepsy and recurring hyponatremia are leading in Primary Empty Sella Syndrome A case report

I Gusti Agung Gede Ariswanda, Tommy Sarongku, Sri Yenni Trisnawati GS, DPG Purwa Samatra, I Putu Eka Widyadharma.

Abstract
Empty sella syndrome is a neuroendocrine disorder rarely in population. Often occurred with a female : male = 4:1, in middle age, and obesity.
Report : We present a case of a 27-year-old male, short structure, BMI 20,4 kg/m2, undecending testes. He was diagnosed with epilepsy symptomatic. The first symptoms occurred when he was 25 years old with general-tonic clonic pattern, blood test were showed normal only found low hyponatremia, brain MRI and EEG were abnormal. Unfortunaley, his seizure was not relieved with medical management, phenytoin for 2 years. Prolong seizure occurred, he had status epilepticus. Brain MRI showed empty sella, moderate enchepalopaty with EEG, serial severe hyponatremia (105 mEq/L), and loss sodium urine. Subsequently, seizure relieves controlled with normal sodium level by mineralcorticoid drug

Key words: Short stucture, undescending testes, severe hyponatremia, seizure


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