# Neurogenic Pulmonary Edema Associated with Hyponatremia, Primary Polydipsia, and Cannabis Use: A Case Report

## TL;DR

A 34-year-old woman developed life-threatening lung fluid after cannabis use, excessive water drinking, and a seizure caused by low sodium levels.

## Contribution

First documented case linking cannabis, polydipsia, hyponatremia, and neurogenic pulmonary edema.

## Key findings

- Cannabis edible consumption preceded excessive water intake and seizure.
- Severe hyponatremia led to status epilepticus and neurogenic pulmonary edema.
- Case emphasizes the need for awareness of this rare but dangerous interaction.

## Abstract

Neurogenic pulmonary edema is a rare and potentially life-threatening condition that can present as severe pulmonary edema after significant neurologic insults. This is the first documented instance that shows a plausible causal link between cannabis consumption, psychogenic polydipsia, and the subsequent development of neurogenic pulmonary edema associated with status epilepticus secondary to acute hyponatremia.

We report a case of a 34-year-old female who presented to the emergency department altered and postictal after a witnessed new-onset seizure. She developed significant respiratory distress that required intubation. Her sodium was 121 millimoles per liter (mmol/L), from 137 mmol/L 36 hours prior on routine outpatient labs. Further history revealed excessive water ingestion after eating a cannabis edible prior to the seizure.

This case highlights the importance of recognizing neurogenic pulmonary edema in connection with psychogenic polydipsia, severe hyponatremia, and status epilepticus subsequent to cannabis consumption.