Hyponatremia, Seizure, Cancer, SIADH

43 F with first-time generalized seizure undergoing treatment for breast cancer. Presents to the ED with no history of trauma or fever. Currently undergoing new chemotherapy for breast cancer, and no other collateral available such as recent oncology notes nor spouse.

Goals and Objectives

Educational Goal:

• Prioritize cessation of seizure and identify causal factor(s) in patient with probable metastatic breast cancer.

CRM Objectives:

• Empathetic communication with spouse in terms of what the seizure may mean.
• Exploration of goals of care with partner in regards to new medical development (seizure requiring intubation for airway protection).

Medical Objectives:

• Stabilize patient with first time seizure.
• Prioritize investigations and treatments in the context of possible metastatic breast cancer.
• Provide a differential diagnosis for seizure in patient with query metastatic breast cancer.