Summary

This is a case report highlighting the impact of low sodium levels on one’s mental status. For the first time in the literature, we see two discrete episodes of catatonia associated with hyponatraemia occurring in the same patient. On both occasions, his serum sodium levels were depleted; he became profoundly psychotic with catatonic symptoms. Recovery, with complete resolution of all symptoms, was associated with normalisation of these levels. This case exemplifies the profound effect that electrolyte imbalances, in particular sodium depletion can have on a patient’s mental status and is for the first time, we see this effect on two temporally unrelated occasions in the same patient.