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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

80 strictly selected patients with chronic renal insufficiency with plasma creatinine values of 1.4--14.5 mg% were examined according to a fixed scheme to determine the presence of symptoms and signs of renal encephalopathy. The general cerebral symptoms complained of were headache in 33.4% of the patient material, dizziness in 30.3%, easy fatigability in 62.5%, giddiness in 18.8% and insomnia in 37.5%. The most prominent neurological findings were hyperactive deep reflexes in 30% and action tremor in 23.8%. The symptoms of organic brain syndrome were impairment of memory in 32.5%, weakness of concentration in 28.8% and lability of affect in 63.7%. Diffuse EEG abnormalities were found in 26.2%. While the clinical neuropsychiatric symptoms did not show any statistically significant correlation with the various internal medical data, a trend was observed in the greater number of pathological EEGs with an increase in the impairment of renal function. Furthermore, there was a statistically significant correlation, (alpha less than or equal to0.015) between the occurrence of pathological EEGs and the plasma creatinine and BUN values. It is remarkable that the patients with abnormal EEGs had a relatively low mean creatinine level of 5.89 mg%. The strict dietetic management of the patients is regarded as one of the deciding factors for the relatively low frequency of neuropsychiatric symptoms in the material studied.
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PMID:Neuropsychiatric symptomatology with chronic renal insufficiency in the stage of compensated and decompensated retention. I. CNS disturbances. 5 91

The consequences of chronic renal insufficiency relevant to hepatic failure are not well appreciated. We describe a patient with chronic cirrhosis and marked porto-systemic shunting who, after the onset of chronic renal failure, developed intractable encephalopathy which improved markedly during an eight month period of maintenance hemodialysis.
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PMID:Exacerbation of hepatic encephalopathy by chronic renal failure: response to maintenance hemodialysis. 66 27

The authors studied the traits of psychotic attacks in 40 patients with terminal stages of chronic renal insufficiency. They were expressed in atypical delirious, delirio-amentive and amentive conditions. 8 cases were studied morphologically. The pathological process in the brain was characterized as toxico-dyshomeostatic encephalopathy. The pathogenesis of such disorders is discussed.
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PMID:[Features of episodes of mental disorders in chronic renal insufficiency (clinico-morphologic study)]. 96 Dec 87

In view of the increasing pollution of our environment and forest decline, growing interest has been focused on aluminum toxicity. Aluminum is one of the most abundant metals and commonly present in tap water, beverages, food, cosmetics, and pharmaceutical preparations. Thus everybody is exposed to aluminum to a greater or lesser extent. It is now beyond any doubt that aluminum intoxication may cause encephalopathy, fracturing vitamin D resistant osteomalacia, and microcytic anemia in patients with chronic renal insufficiency as well as in experimental animals. The risk of aluminum intoxication has also to be considered in several other groups. These include elderly individuals with physiologically impaired excretory renal function who are treated with aluminum-containing antacids, patients with chronic liver disease, infants who are fed highly aluminum-contaminated formula at a time when their excretory renal function has not jet fully developed, patients on total parenteral nutrition, and, possibly, patients with Alzheimer's disease.
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PMID:[Aluminum toxicity]. 251 13

Severe myoclonus, generalized seizures, and marked stupor occurred in a 39-year-old woman with chronic renal insufficiency after one week of moxalactam 2 g iv q8h. Moxalactam serum levels far exceeded the recommended therapeutic range. The drug half-life was 17 hours (normal 1.9). Excessively high levels of moxalactam, which penetrates the blood-brain-barrier relatively easily, may provoke seizures and encephalopathy.
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PMID:Moxalactam myoclonus, seizures, and encephalopathy. 395 81

Longitudinal EEG studies were performed under three different clinical conditions during 15 haemodialysis in chronic renal insufficiency. The relationship of EEG changes to clinical and biochemical parameters and to the subjective state of wellbeing was examined. The relevance of EEG monitoring as a method of assaying the adequacy of haemodialysis was investigated. By means of pre- and post-dialysis examinations it was found in 13 out of 15 measurements that a decrease in Creatinin serum concentration was accompanied by an increase in alpha index and that in 14 out of 15 measurements shift in the power spectrum toward the faster frequencies occurred. In those cases where a reduction in alpha index respectively an increase in theta index was found, the possibility of subacute dialysis encephalopathy must be taken in account. No significant relationship between subjective state of well-being and dialysis was found, with the exception of one patient, who had recently been admitted to the dialysis program. The results demonstrate the diagnostic relevance of EEG monitoring during haemodialysis in chronic renal insufficiency. However, the prognostic relevance remains to be proven with a larger number of patients.
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PMID:[EEG-changes during haemodialysis in chronic renal insufficiancy (author's transl)]. 677 42

A retrospective analysis of children with renal failure during the first year of life revealed that 20 of 23 patients developed profound neurologic abnormalities. The encephalopathy was characterized by developmental delay, microcephaly, hypotonia, seizures, dyskinesia, and EEG abnormalities. No patient had been dialyzed, and four had not received aluminum salts prior to the development of neurologic symptoms. Inadequate statural growth and poor nutrition were present in all patients. It is probable that infants with chronic renal insufficiency are more susceptible to the development of this syndrome than are older children or adults because of the significant growth and maturation of the brain that occurs during the first years of life.
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PMID:Progressive encephalopathy in children with chronic renal insufficiency in infancy. 708 84

By the end of a dialysis session the patient had a generalized convulsive seizure. Then meningeal syndrome, right-sided hemiparesis with central lesion of right facial nerve and bilaterally positive extensor plantar response were found. Because of the increase of blood pressure and then increased body temperature the diagnosis of acute hyponatraemic encephalopathy was not made only on the basis of the plasma ionogram (Na+ 110mEq/1) but also after excluding possible subarachnoid haemorrhage and acute cerebrospinal meningitis and encephalitis by cerebrospinal fluid examination. Hyponatraemia found in some patients suffering from chronic renal insufficiency is increased by haemodialysis session. Cerebral oedema which is proportional to natraemia is caused by urea disolation from intracellular to extracellular fluid. This process increases concentration gradient between intracellular and extracellular fluids. The perceptible neurological signs occur as natraemia declines below 120 mEq/l.
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PMID:[Acute hyponatraemic encephalopathy in a patient on chronic hemodialysis program -- a case report]. 850 50

Tryptophan (TRP) metabolism via the kynurenine pathway leads to formations of neuroactive substances like kynurenine (KYN) and 3-hydroxykynurenine (3-HK), which may be involved in the pathogenesis of several human brain diseases. 3-Hydroxykynurenine especially is known to have strong neurotoxic properties. The generation of reactive oxygen species (ROS) leads to neuronal cell death with apoptotic features. Because the chronic renal insufficiency (CRI) results in disturbances in the functioning of the central nervous system (CNS), it is conceivable that the metabolism of some kynurenines may be altered and could play an important role in uremic encephalopathy. The levels of TRP, KYN and 3-HK were measured in the plasma and in different brain regions of uremic rats. The total plasma concentration of TRP as well as in all the studied brain samples was significantly diminished during uremia. Surprisingly, the level of KYN and 3-HK were elevated both in the plasma and different brain regions of CRI animals. KYN concentrations were approximately two times higher in the cerebellum, midbrain and cortex compared to the control group. The changes of 3-HK levels were more pronounced in the striatum and medulla than in other structures. This data suggests that CRI results in deep disturbances on the kynurenine pathway in CNS, which could be responsible for neurological abnormalities seen in uremia.
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PMID:Increased levels of 3-hydroxykynurenine in different brain regions of rats with chronic renal insufficiency. 1218 21

A 67-year-old woman with diabetes mellitus, chronic renal insufficiency, and recurrent urinary tract infections experienced encephalopathy and myoclonus while receiving cefepime. The adverse drug event was accompanied by elevated cefepime levels and abnormal electroencephalograms. This syndrome resolved after discontinuation of cefepime. Neurotoxicity is a known but possibly underreported adverse event associated with cefepime in patients with renal impairment who receive relatively excessive doses. Most cases reverse on drug cessation. In patients with renal disease, the maintenance dosage should be reduced and the patient monitored for neurotoxicity. Cefepime toxicity should be suspected whenever a patient receiving the drug experiences a change in mental status or myoclonus.
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PMID:Cefepime neurotoxicity: case report, pharmacokinetic considerations, and literature review. 1686 93


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