Adrenal crisis induced-seizures: A Case report and literature review

This case report underscores the critical interplay between adrenal crisis and seizure activity, emphasizing the importance of rapid recognition and management of this life-threatening condition. Adrenal crisis, characterized by severe hypotension and electrolyte disturbances, often manifests with nonspecific symptoms such as fatigue, nausea, and altered consciousness, which can obscure diagnosis, especially in pediatric and young adult populations. The report details a 21-year-old female with a complex endocrinologic background who developed seizures precipitated by an adrenal crisis triggered by gastroenteritis and compounded by medication noncompliance. Clinical findings included profound dehydration, electrolyte abnormalities, refractory hypotension, and low cortisol levels, which responded favorably to prompt hydrocortisone administration. The case highlights the importance of a high index of suspicion in patients presenting with unexplained shock and seizures, particularly when standard treatments fail and laboratory abnormalities are present. The discussion explores the pathophysiological connection between stress hormones, the hypothalamic-pituitary-adrenal axis, and neuronal excitability, illustrating how dysregulation can predispose to seizures. It emphasizes the need for immediate endocrine intervention, airway protection, broad-spectrum antibiotics when infection is suspected, and comprehensive patient education to prevent recurrence. This report advocates for multidisciplinary collaboration in managing adrenal crisis and stresses the vital role of early glucocorticoid therapy to reduce mortality. Educating patients on sick-day management and ensuring access to emergency medications are crucial for effective prevention. Overall, recognizing adrenal crisis as a reversible cause of seizure and shock is paramount for improving outcomes and reducing associated morbidity and mortality.