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What is the most likely cause of this patient’s presentation and what is the most appropriate next step?
The patient’s CT head is unremarkable.
He is given IV Lorazepam and while the nurses are preparing the hypertonic saline he has a further seizure.
On reassessment, his observations are unchanged, but his GCS is now 8/15 (E2 M4 V1).
His repeat VBG shows a further drop in his Sodium to 106, with a potassium of 3.4
His renal function is normal.
You arrange for an urgent anaesthetic review as you are concerned about his airway. What is the most appropriate next step?
Which of the following are recognised causes of acute hyponatraemia?