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HISTORY & CASE SUMMARY :-
This 64 years old male presented with C/o altered behavior since 1 day. The patient is k/c/o - Hypertension
on regular medication. The patient was admitted and routine investigation done, serum sodium -119,
serum potassium - 4.0, CBC-Hb- 14.1, WBC- 13000, platelet -3.49 lacs, HBA1C- 6.3%, Total IgE-46.16,
LFT - Total Bill - 0.58, SGOT-32.6, SGPT- 16.8, RFT, urea-13.0, Creatinine - 0.76, the patient was
started on 3% nacl infusion and Nat-level corrected to 127. The patient's sensorium improved and was
stabilized, urine R/M- normal, USG abdomen fatty hepatomegaly (Grade-I), BPH - (Grade-I). a
psychiatrist opinion was taken I/V/O - acute psychosis and advise followed. The next day serum sodium
-133.0. the patient was given BZD, NS (IV fluids), antibiotics, anti-psychotic, analgesic, PPI,
anti-hypertensive, antiepileptic, the patient improved gradually and is being discharged in stable condition,
But in home , he continues senseless speaking
Answers (6)
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Hi,
The best way ahead would be a detailed clinical interview to understand the symptoms and your comprehensive history.
For a personalized plan, find me by searching "Dr Abhinav Tewari Neuropsychiatrist Lucknow" on Google Maps — my details are listed there.
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Kind Regards,
Dr Abhinav Tewari
Consultant Neuro-Psychiatrist
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MD (Psychiatry) (A.I.I.M.S., New Delhi)
DNB (NBEMS)
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Hello,
The patient’s altered behavior was most likely related to low sodium (hyponatremia), which improved after correction with saline. However, sometimes confusion, disorganized speech, or abnormal behavior can persist for a while even after sodium levels are corrected, especially in older adults.
Next Steps
1. Ensure the patient takes all prescribed medicines regularly.
2. Watch for warning signs: worsening confusion, fever, severe headache, seizures, or agitation.
3. Keep follow-up with both the treating physician and psychiatrist, as additional evaluation or medication adjustments may be needed.
4. Maintain adequate hydration and nutrition.
Visit the nearest hospital emergency or
For more queries, Reach out for an online or in-person consultation:
📞 NEURONAL FIX CLINIC, RAMPRASTHA COLONY, Ghaziabad, (near Shreshtha Vihar, Delhi)- +91- 74XX52XX97XX67XX61
Health Tips
1. Do not stop or add any medicines without the doctor’s advice.
2. If the “senseless speaking” worsens or new symptoms appear, bring the patient back to the hospital promptly.
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Hi.. consult online for treatment
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Please go for a second opinion. One from an internal medicine specialist, other from a neurologist with all the test report and history.
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Dr. Sanjana Ilavarasu
Psychiatrist
3 yrs exp
Bangalore
Could be a stroke considering age, history of hypertension and symptoms persisting despite sodium correction. Has the patient been evaluated by a neurologist? Any imaging like CT done?
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.