Reversible Uremic Encephalopathy with Acute Parkinsonism
Deok-Hyun Heo, MD, Do-Eui Kim, MD, Kyung-Bok Lee, MD, Hakjae Roh, MD and Moo-Young Ahn, MD
Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Korea
ABSTRACT
Background: Uremic encephalopathy involving cerebral cortex is well-known complication of uremia. But acute parkinsonism with bilateral basal ganglia lesion is unusually reported in patients with end stage renal disease. Case Report: A 60-years-old man presented with gait disturbance which developed suddenly 1 week before admission. He had been diagnosed with non-insulin dependent diabetes and advanced renal failure. The neurological examination revealed bradykinesia and cognitive impairment. Blood urea nitrogen and serum creatinine were elevated in laboratory test. Brain magnetic resonance imaging (MRI) showed abnormal findings in the bilateral basal ganglia and the left parietal gyrus (cortex). After increasing the frequency of hemodialysis, his symptoms and lesions of MRI nearly disappeared. Conclusions: We report a case of uremic encephalopathy presented simultaneous acute parkinsonism with bilateral basal ganglia and unilateral cortical lesion.
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