Hiccups to hyponatremic encephalopathy: A rare presentation of acute water intoxication in a patient after uroflowmetry

ABSTRACT

Benign prostatic hyperplasia (BPH) commonly presents with lower urinary tract symptoms and requires preprocedural bladder filling for urologic evaluation. A 61-year-old male with BPH, diabetes, and hypertension developed altered sensorium, behavioral changes, hiccups, and a single episode of generalized tonic–clonic seizure after consuming 4 L of water during 2 h prior to uroflowmetry and ultrasound. Investigations showed hypotonic hyponatremia (serum sodium: 109 mEq/L). Other causes were excluded, and prompt treatment with hypertonic saline and fluid restriction was initiated, resulting in full recovery. Acute water intoxication causing dilutional hyponatremia is a rare but preventable complication requiring awareness and proper hydration guidance, especially in the elderly.