| Recurrent Acute Uremic Encephalopathy Associated with Reversible Bilateral Basal Ganglia Lesion |
| Ja Sung Choi, M.D.1, Jeong Hun Kim, M.D.1 , Byung Soo Jeon, M.D.1 Kyung Suk Park, M.D.1, Myoung Lyeol Woo, M.D.1, Sang Choel Lee, M.D.1 Eun Ja Lee, M.D.2 and Soo Young Yoon, M.D.1 |
Department of Internal Medicine1
Radiology2 , College of Medicine, Kwandong University, Goyang, Korea |
| 증례 : 가역성 양측 기저핵 병변을 동반한 반복적인 급성 요독성 뇌병증 1예 |
| 최자성1•김정훈1•전병수1•박경석1•우명렬1•이상철1•이은자2•윤수영1 |
| 관동대학교 의과대학 내과학교실1, 영상의학과교실2 |
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| Abstract |
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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.
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| Key Words:
Diabetic nephropathy, Uremia, Basal ganglia |
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