Absence of Thirst in Association with Hydrocephalus

DEHYDRATION is commonly seen in patients with impaired consciousness whose thirst mechanism is undamaged, but who are unable to ask for water.1 A few cases have been described, however, in conscious patients who, for a variety of reasons, have lost the ability to experience thirst. Avioli and his associates,2 for example, have recently reported absence of thirst in a twelve-year-old girl with extensive hypothalamic damage caused by Schüller–Christian disease. In the case presented below, the patient, although fully alert and carrying on normal activities, required hospitalization twice in a five-year period for severe dehydration and hypernatremia. Investigation revealed an inability . . .