Monitor the serum electrolyte levels in order to ensure adequate fluid intake. The level of comprehension and compliance of the patient and parents determines the frequency of the visits. In children with normal AVP secretion, measuring urine osmolality may be sufficient for follow-up care. Existing neurological deficits can be exacerbated by acute episodes of severe hypernatremia and cerebral hemorrhage. Extrarenal losses of volume during episodes of gastroenteritis, more common in children, may lead to rehospitalization for worsening hypernatremia or other disorders of serum electrolytes.
Prognosis is unfavorable unless behavioral therapy is successful.
Most patients remain homebound or institutionalized and may develop further neurological handicaps. Educate the patient and the caregivers to ensure that they understand how to adjust fluid intake to account for usual daily needs. Insufficiently frequent or inadequate outpatient supervision may be a medicolegal pitfall. Pituitary and hypothalamic dysfunction in a patient with a basal encephalocele. Report of three cases and review of the literature.