Department of Neurology, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland.
J Neurol Sci. 2010 Oct 15;297(1-2):74-5. doi: 10.1016/j.jns.2010.07.016. Epub 2010 Aug 14.
The syndrome of acute bilateral basal ganglia lesions is a rarely described complication of uremia occurring typically in the setting of concurrent long-standing diabetes mellitus. Reversible symmetrical lesions located in basal ganglia found on brain magnetic resonance imaging are hallmarks of this syndrome. Clinical presentation includes parkinsonism and/or involuntary movements. The cause of this syndrome is largely unknown. Among the factors that are believed to contribute to its pathogenesis are uremic toxins, metabolic acidosis and diabetic microangiopathy. Here we report a patient with uremia and newly diagnosed diabetes, who developed the syndrome of acute bilateral basal ganglia lesions after an incidence of severe hypoglycemia induced by oral hypoglycemic agents. We consider hypoglycemia as a candidate trigger factor for the syndrome of acute bilateral basal ganglia lesions and highlight the importance of strict glucose control in uremic patients.
急性双侧基底节病变综合征是一种罕见的尿毒症并发症，通常发生在长期合并糖尿病的情况下。磁共振成像显示基底节可逆性对称病变是该综合征的特征。临床表现包括帕金森病和/或不自主运动。该综合征的病因尚不清楚。据信导致其发病机制的因素包括尿毒症毒素、代谢性酸中毒和糖尿病微血管病变。在这里，我们报告了一例尿毒症和新诊断为糖尿病的患者，他在口服降糖药引起严重低血糖后发生急性双侧基底节病变综合征。我们认为低血糖是急性双侧基底节病变综合征的一个候选触发因素，并强调严格控制尿毒症患者的血糖水平的重要性。
