Korean J Nephrol.  2008 Jan;27(1):154-157.

Recurrent Acute Uremic Encephalopathy Associated with Reversible Bilateral Basal Ganglia Lesion

• Choi JS
• Kim JH
• Jeon BS
• Park KS
• Woo ML
• Lee SC
• Lee EJ
• Yoon SY

Abstract

Uremic encephalopathy is a well-known complication in uremia and rarely occurs with involuntary movements which represent basal ganglia lesion. We experienced a cases of recurrent acute uremic encephalopathy associated with reversible bilateral basal ganglia lesion. A 49-year-old man with end stage renal disease due to diabetic nephropathy on continuous ambulatory peritoneal dialysis (CAPD) treatment for the last 2 months was admitted for mental change. His blood sugar was 60 mg/dl, and his mentality was recovered after glucose solution infusion. Five days after admission, he suddenly developed dysarthria and chorea. Brain magnetic resonance imaging (MRI) demonstrated low and high signals on bilateral basal ganglia in T1-weighted and T2-weighted images, respectively. After intensified CAPD treatment, his neurologic manifestations were resolved. One month after discharge, follow-up brain MRI showed decreased size of low attenuation on the basal ganglia. Two months later, he repeatedly developed dysarthria and involuntary movement of extremities. Newly developed bilateral symmetric T1 low and T2 high signal lesion on the basal ganglia was repeatedly observed on brain MRI. At that time, (his) Kt/V was 1.33. So we decided on him to switch from CAPD to hemodialysis, after then his symptoms disappeared.

Keyword

Diabetic nephropathy; Uremia; Basal ganglia

MeSH Terms

Basal Ganglia
Blood Glucose
Brain
Chorea
Diabetic Nephropathies
Dysarthria
Dyskinesias
Extremities
Follow-Up Studies
Glucose
Humans
Kidney Failure, Chronic
Magnetic Resonance Imaging
Middle Aged
Neurologic Manifestations
Peritoneal Dialysis, Continuous Ambulatory
Renal Dialysis
Uremia
Blood Glucose
Glucose