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RESEARCH PRODUCT

Acute reversible parkinsonism in a diabetic-uremic patient.

Federico PiccoliChiara CupidiVincenzo La Bella

subject

medicine.medical_specialtyMovement disordersacute parkinsonismGastroenterologyWhite PeopleDiabetes Complicationschemistry.chemical_compoundParkinsonian DisordersDiabetes mellitusInternal medicinemedicineHumansAgedUremiaCreatininediabetes mellitubusiness.industryParkinsonismGeneral Medicinemedicine.diseasePathophysiologyUremiaSurgerychemistryCreatininebasal gangliaAcute DiseaseSurgeryFemaleNeurology (clinical)medicine.symptomDifferential diagnosisbusinessKidney disease

description

Acute movement disorders with basal ganglia lesions have been recently described in diabetic-uremic patients of Asian descent. The process is often reversible, with a favourable clinical outcome. Metabolic (i.e. uremic toxins) and microangiopathic changes have been suggested to be involved in its pathophysiology, even though racial and/or genetic factors might play a role too. In this report, we present a Caucasian diabetic patient with a long-lasting mild uremia in which acute parkinsonism occurred after a steep and unexpected increase of the serum creatinine. The follow-up demonstrated a significant improvement of the neurological signs and symptoms, the creatinine level lowered close to the premorbid levels, and after several months the patient had fully recovered. Our case history suggests that this unusual clinical syndrome is most probably not restricted to Asian patients. Because its potentially favourable outcome, it should be regularly included in the differential diagnosis of acute movement disorders

10.1016/j.clineuro.2005.04.002https://pubmed.ncbi.nlm.nih.gov/15885881