Sir.—We read with interest the report by Mor et al in the January issue of the Journal (129:133, 1975), describing an infant with pneumonia who developed the syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia. In this case, it was not until three days after hospitalization for pneumonia that the child developed hyponatremia and seizures. We would like to report the cases of two children who had status epilepticus secondary to hyponatremia, probably resulting from clinically occult pneumonias. In addition, we wish to comment on the use of hypertonic saline in such cases.
Report of Cases.—Case 1.—An 8-month-old girl developed bilateral tonicoclonic seizures after being seen earlier in the day with otitis media. Seizures were terminated with administration of diazepam, phenobarbital, and paraldehyde. The child was comatose with a temperature of 36.5 C (97.7 F) and blood pressure of 80/60 mm Hg; weight was 8 kg