Refractory epilepsy and recurring hyponatremia are leading in Primary Empty Sella Syndrome A Case Report

Empty Sella syndrome is a neuroendocrine disorder rarely in population. Often occurred with a female: male = 4:1, in middle age, and obesity. Report: We present a case of a 27-year-old male, short structure, BMI 20,4 kg/m2, undescended testes. He was diagnosed with epilepsy symptomatic. The ?rst symptoms occurred when he was 25 years old with the general-tonic clonic pattern; blood test was showed normal only found low hyponatremia, brain MRI and EEG were abnormal. Unfortunately, his seizure was not relieved with medical management, phenytoin for two years. Prolong seizure occurred; he had status epilepticus. Brain MRI showed empty Sella, moderate encephalopathy with EEG, severe serial hyponatremia (105 mEq/L), and loss of sodium urine. Subsequently, seizure relieves controlled with normal sodium level by mineralocorticoid drug. Conclusions: Clinicians should be aware of the typical signs of an empty sell for its proper diagnosis & management.