Periodic hyperammonemic encephalopathy associated with a ureterosigmoidostomy.
Ureterosigmoidostomy, a urinary diversion procedure performed for treatment congenital urologic defects or bladder cancer, may be associated with hyperammonemia. A delayed periodic encephalopathy, characterized by dysarthria, ataxia, and coma, developed in a 44-year-old woman who had undergone this procedure. Hyperammonemia-associated neurotoxicity resolved after surgical revision of the ureterosigmoidostomy to a uretero-ileostomy. Therefore, a treatable episodic encephalopathy may occur in association with hyperammonemia in patients who have undergone ureterosigmoidostomy.
Cascino
G D
GD
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Jensen
J M
JM
Nelson
L A
LA
Schutta
H S
HS
D000328:Adult; D000641:Ammonia / Q000097:blood*; D001928:Brain Diseases, Metabolic / Q000097:blood* / Q000175:diagnosis; D012809:Colon, Sigmoid / Q000601:surgery; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D012086:Reoperation; D014519:Ureterostomy / Q000379:methods; D014547:Urinary Diversion / Q000009:adverse effects*
D000641:Ammonia