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- W2134056422 abstract "Setting: Acute rehabilitation hospital. Patient: A 44-year-old man with history of hypertension and diabetes was admitted for right middle cerebral artery cerebrovascular accident. Case Description: The patient was admitted to inpatient rehabilitation service with resultant left-sided hemineglect and hemiparesis. At that time, the patient was at a moderate assistance level for transfers, ambulation, and activities of daily living. It was also noted that the patient had a flat affect and exhibited other signs of depression. Psychiatry was consulted and the patient was started on sertraline for poststroke depression. The patient made excellent gains in physical therapy and was subsequently able to ambulate greater than 90m (300ft) with a straight cane. Prior to discharge, the patient became increasingly more lethargic, somnolent, and confused. A mental status workup was initiated and a noncontrast head computed tomography showed no acute changes. A review of lab studies revealed a sodium level of 120mmol/L. On physical exam, the patient was euvolemic. Assessment/Results: The patient was diagnosed with hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone release (SIADH). The patient’s sertraline was held and the hyponatermia slowly resolved, along with the patient’s confusion. Discussion: According to recent studies, upward of 60% of patients who are poststroke suffer from depression. This case represents a complication of treatment of early poststroke depression. The increasing use of selective serotonin reuptake inhibitiors (SSRIs) in poststroke patients and their potential side effects need to be fully understood by physiatrists leading to improved monitoring of laboratory as well as clinical markers. Conclusions: Although poststroke depression remains a significant complication and needs to be addressed, physiatrists who are involved in the care of these patients must understand the potential side effects of SSRIs to avoid complications such as mental status change secondary to SIADH." @default.
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- W2134056422 date "2007-09-01" @default.
- W2134056422 modified "2023-09-27" @default.
- W2134056422 title "Poster 316: Poststroke Depression and Acute Mental Status Change: A Case Report" @default.
- W2134056422 doi "https://doi.org/10.1016/j.apmr.2007.06.734" @default.
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