“Metabolic Encephalopathy in a Hypertensive Patient with Hyponatremia: A Case Report”

Abstract

Background: Metabolic encephalopathy is a reversible neurological disorder caused by systemic metabolic disturbances. Hyponatremia is a common electrolyte imbalance associated with altered sensorium, and its impact can be amplified in patients with chronic hypertension, potentially leading to severe cerebral dysfunction.

Objectives: To present a case illustrating the interplay between acute hypertensive crisis and metabolic derangement, emphasizing the importance of early recognition and management in preventing neurological deterioration.

Methods: We report the clinical course of an 80-year-old hypertensive female who presented with sudden loss of hearing and vision, confusion, restlessness, nausea, and headache. Vital signs, laboratory investigations, and immediate interventions, including intravenous antihypertensive therapy, were documented.

Results: On presentation, the patient had a blood pressure of 220/104 mmHg and was administered 20 mg IV Labetalol. Rapid intervention stabilized her blood pressure and prevented progression of metabolic encephalopathy. No prior cerebrovascular events were noted, though the patient had a history of myocardial infarction. Prompt management led to stabilization of neurological and metabolic status.

Conclusions: This case underscores the critical need for early recognition and management of hypertensive crises in patients at risk of metabolic encephalopathy. Controlling blood pressure and correcting metabolic imbalances can prevent rapid neurological decline and improve patient outcomes.