title: Dexmedetomidine controls twitch-convulsive syndrome in the course of uremic encephalopathy.
abstract: An 85 year old man with a history of chronic renal insufficiency was admitted to the cardiothoracic intensive care unit after aortic valve replacement. His postoperative course was marked by acute oliguric renal failure for high blood urea nitrogen (BUN) and acute hyperactive delirium. At this time he also developed tremors with muscle twitching; he received no other form of sedatives. A neurology consult made the diagnosis of twitch-convulsive syndrome associated with uremic encephalopathy. While the patient was receiving the dexmedetomidine infusion, the signs of the twitch-convulsive syndrome, particularly the twitching and tremors, disappeared. Within 30 minutes of the end of the dexmedetomidine infusion, symptoms of the twitch-convulsive syndrome returned, manifesting as acute tremulousness. After several dialysis treatments, his BUN decreased and the dexmedetomidine was weaned, without return of the symptoms of twitch-convulsive syndrome.
authors.affiliation: Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY 10029, USA. koichi.nomoto@mountsinai.org
authors.forename: Koichi
authors.initials: K
authors.lastname: Nomoto
authors.forename: Corey
authors.initials: C
authors.lastname: Scurlock
authors.forename: David
authors.initials: D
authors.lastname: Bronster
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology*; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery; D001927:Brain Diseases / Q000503:physiopathology*; D003693:Delirium / Q000209:etiology; D020927:Dexmedetomidine / Q000494:pharmacology*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology; D012640:Seizures / Q000209:etiology; D013577:Syndrome; D013997:Time Factors; D014202:Tremor / Q000209:etiology; D014511:Uremia / Q000503:physiopathology*
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine