70M Quadriparesis and post admission vomiting and Hyponatremia Telangana PaJR

 

15-11-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

[4.10 pm, 15/11/2025] PPM 1: History on admission.

[4.11 pm, 15/11/2025] PPM 1: CNS examination by @PPM3

https://youtu.be/akn_FGigcD0?si=B-XLkmYyVPM6d4V6

                                        

[4:14 pm, 15/11/2025] PPM 1: @PPM3 before you share his MRI can you share his x-rays of cervical and lumbar spine?

[4:20 pm, 15/11/2025] PPM 4: Sir any information on vibration sensation, fine touch, pain, Babinski?

[4:34 pm, 15/11/2025] PPM 1: 👆@PPM3?

[4:34 pm, 15/11/2025] PPM 1: 👆@PPM5?

[9.51 pm, 15/11/2025] PPM 1: 

[3.33 pm, 17/11/2025] PPM 1: 

[3:46 pm, 17/11/2025] PPM 1: Admitted in orthopedics for the road traffic accident and Quadriparesis for spinal surgery but on 6/11/25; noticed to have altered sensorium with hyponatremia for which transferred to medicine. Time line of his sodium

[4:14 pm, 17/11/2025] PPM 1: 👆@PPM6 @PPM5 @PPM3@PPM7 what is the significance of the 24 hour urinary electrolyte values in this patient who had unexplained hyponatremia after 5 days of admission?

[4:15 pm, 17/11/2025] PPM 1: @PPM5 please explain 👇

[17/11, 16:04]: Sir a small doubt

[17/11, 16:04]: Pt was diagnosed with hypovolemic hyponatremia

[17/11, 16:05]: But he is on Tolvaptan ć SIADH .. but SIADH is euvolemic hyponatremia right ? Sir

[17/11, 16:05]: Couldn't understand the concept

[4.18 pm, 17/11/2025] PPM 1: On 5/11/25 reviewed by anesthesiology for planned spinal cord decompression for his traumatic compressive myelopathy @PPM5 please share the MRI images of that. He didn't have hyponatremia then. Something happened that day or next day when it was suddenly found that his serum sodium was 127 and @~Harshini did he become altered sensorium the same day?

The spinal surgeon's note on 6/11/25

[4.25 pm, 17/11/2025] PPM 1:The patient's spinal traumatic compression due to slipping on the road was compounded by the prior existence of the usual Narketpally fluorotic changes in his cervical vertebrae and ligaments

[4:26 pm, 17/11/2025] PPM 1: 👆@PPM5 send the images

[4.27 pm, 17/11/2025] PPM 1: This patient will go to both our OPLL ProJR as well as csvd ProJR