Central pontine and extrapontine myelinolysis owing to disequilibrium syndrome.
Neurologic disorders can be seen in patients with end-stage renal failure owing to complications of hemodialysis or peritoneal dialysis. The disequilibrium syndrome can be seen, usually soon after or toward the end of dialysis. We report a patient with central pontine and extrapontine myelinolysis owing to disequilibrium syndrome. The patient had depressed consciousness, agitation, tremor, stupor and hyperactive deep tendon reflexes toward the end of the second peritoneal dialysis. A brain computed tomographic (CT) scan showed hypodense lesions in pontine and extrapontine locations without radiocontrast medium enhancement After 2 days, the patient had only minimal memory deficits. A control brain CT scan 1 week later showed a decrease of the lesions in central pontine and extrapontine locations. Central pontine and extrapontine myelinolysis should be suspected and investigated in the acute neurologic disorders of dialysis patients.
Aydin
Omer Faruk
OF
Department of Pediatric Neurology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey. ofaydin@yahoo.com
Uner
Ciğdem
C
Senbil
Nesrin
N
Bek
Kenan
K
Erdoğan
Ozlem
O
Gürer
Y K Yavuz
YK
D002648:Child; D005260:Female; D006801:Humans; D017590:Myelinolysis, Central Pontine / Q000000981:diagnostic imaging* / Q000209:etiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014883:Water-Electrolyte Imbalance / Q000150:complications* / Q000000981:diagnostic imaging*