Anatomical defects of the midbrain, such as septo-optical dysplasia with the agenesis of the corpus callosum, holoprocephalus, etc., may be associated with central diabetes insipidus. These patients do not always have external signs of cranial-anomalies.
Primary nocturnal enuresis
In healthy children, there is a nocturnal increase in vasopressin levels associated with an increase in urine osmolarity and a decrease in its volume. Thus, the daily diurnal rhythm of urine excretion normally prevails. Children with primary nocturnal enuresis show a decrease or no increase in vasopressin levels at night and excrete more diluted urine. This suggests that children with nocturnal enuresis have a relative primary vasopressin secretion deficiency.
In the diagnosis of diabetes insipidus significant anamnestic data and complaints. So, first of all, it is necessary to ascertain whether pathological polyuria and polydipsia occur (exceeding 2 liters / m2 / day). The doctor should be interested in the following questions: is there a psychological or psychosocial reason for polyuria or polydipsia? What is the amount of fluid drunk and excreted per day? Does polyuria / polypsia affect the normal activity of the patient? Does night enuresis or nocturia occur? If so, what is the amount of liquid drunk at night? Is there any history or clinical examination showing evidence of deficiency or excessive secretion of other hormones, or the presence of an intracranial tumor?