http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
비당뇨병성 말기신부전증 환자에서 양측성 기저핵 병변과 소뇌 병변을 동반한 요독성 뇌병증
심성록 ( Soung Rok Sim ),이상훈 ( Sang Hun Lee ),장재훈 ( Jae Hoon Jahng ),임재윤 ( Jae Yun Lim ),최유경 ( You Kyoung Choi ),배기선 ( Ki Sun Bae ),박우일 ( Woo Il Park ),김기중 ( Ki Joong Kim ),이경열 ( Kyung Yul Lee ),박형천 ( Hy 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.6
Involvement of central nervous system is a well-known compication in uremic patients. However, development of acute extrapyramidal symptoms with bilateral basal ganglia involvement (acute basal ganglia syndrome), especially in non-diabetic hemodialysis patient is very rare. We report a case of acute basal ganglia syndrome in a non-diabetic hemodialysis patient. A 45-year-old man with autosomal dominant polycystic kidney disease (ADPKD) on chronic hemodialysis treatment for the last 4 years was admitted due to generalized myalgia. On admission, the patient was found to have rhabdomyolysis and intractable metabolic acidosis. Nine days after admission, he suddenly developed dysarthria, lateralizing ataxia, and bradykinesia. Brain MRI demonstrated low and high signals in bilateral basal ganglia and cerebellar vermis in T1-weighted and T2-weighted images, respectively. Intensified hemodialysis treatment combined with general supportive therapy resolved the severe metabolic acidosis and the neurologic manifestations gradually improved. Follow up brain CT scan taken 3 months later showed decreased size of initial low attenuation lesions in bilateral basal ganglia and cerebellar vermis. Although no definite pathophysiology is yet established, severe metabolic disorder is believed to play an important role in development of acute basal ganglia syndrome. Correction of metabolic acidosis and hypoglycemia in our patient lead to improvement in neurologic manifestations and organic brain lesions. Our case suggests that severe metabolic acidosis and hypoglycemia in uremic patient may act as risk factors for acute basal ganglia syndrome even in non-diabetic patient. (Korean J Nephrol 2006;25(6):1061-1066)