Abd El Naby Sameh A, Bahbah Wael A, Kasemy Zeinab A, Mahmoud Asmaa A
Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.
Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.
Front Pediatr. 2020 Nov 16;8:570708. doi: 10.3389/fped.2020.570708. eCollection 2020.
Patients with chronic kidney disease (CKD) on maintenance hemodialysis frequently present with neurological complications. These complications include peripheral neuropathy, encephalopathy, and stroke. To detect the prevalence of neurological manifestations and complications in children with CKD through neurophysiological and neuro-radiological findings. The study included 50 patients with CKD admitted to a pediatric nephrology unit. Their history and complete physical and neurological examination findings had been recorded. All patients underwent nerve conduction, electromyography, electroencephalography, and magnetic resonance imaging of the brain. Fifty children of both sexes (23 males and 27 females) with a mean age of (12.08 ± 3.46 year) were studied. Eleven (22%) patients with CKD developed polyneuropathy, mostly of an axonal polyneuropathy pattern, while 39 (78%) of them showed normal electrophysiological studies. No myopathy was detected. Abnormal electroencephalography findings were detected in 18% of patients, mostly generalized and focal (temporal, occipital, and frontal) epileptogenic activity. Abnormal MRI brain findings were detected in 16% of patients, mostly of encephalomalacia. Uremic neuropathy was highly prevalent in children with CKD on maintenance hemodialysis. They developed polyneuropathy, mostly of an axonal polyneuropathy pattern. EEG is a useful method for early recognition of subclinical uremic encephalopathy and/or epileptogenic activity. Early demonstration and management of uremic neurological conditions may decrease the physical disability of CKD patients.
维持性血液透析的慢性肾脏病(CKD)患者常出现神经并发症。这些并发症包括周围神经病变、脑病和中风。通过神经生理学和神经放射学检查结果来检测CKD患儿神经表现和并发症的患病率。该研究纳入了50名入住儿科肾脏病科的CKD患者。记录了他们的病史以及完整的体格和神经检查结果。所有患者均接受了神经传导、肌电图、脑电图和脑部磁共振成像检查。研究了50名男女儿童(23名男性和27名女性),平均年龄为(12.08±3.46岁)。11名(22%)CKD患者发生了多发性神经病变,大多为轴索性多发性神经病变模式,而其中39名(78%)患者的电生理检查结果正常。未检测到肌病。18%的患者脑电图检查结果异常,大多为全身性和局灶性(颞叶、枕叶和额叶)致痫活动。16%的患者脑部MRI检查结果异常,大多为脑软化。维持性血液透析的CKD患儿中尿毒症性神经病变非常普遍。他们发生了多发性神经病变,大多为轴索性多发性神经病变模式。脑电图是早期识别亚临床尿毒症性脑病和/或致痫活动的有用方法。早期发现和处理尿毒症性神经疾病可能会降低CKD患者的身体残疾程度。