Forced water intake with subsequent hyponatremia is an infrequent but potentially fatal form of child abuse. Emergency personnel are often the first providers to come into contact with victims of abuse; as such, they should consider forced water intoxication as a potential cause of hyponatremia with its associated neurologic symptoms when no other cause of hyponatremia is apparent. Fortunately, if detected early, the condition can usually be treated successfully; however, precious time may be lost in making the diagnosis in the emergency department, as perpetrators of the abuse are frequently reluctant to report the child’s excessive water intake.
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