Sasaki Ryo, Matsuoka Chika, Yamashita Toru, Kinomura Masaru, Abe Koji
Department of Neurology, Okayama University, Okayama City, JPN.
Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, JPN.
Cureus. 2023 Mar 13;15(3):e36104. doi: 10.7759/cureus.36104. eCollection 2023 Mar.
Myoclonus, a rare complication in patients with end-stage renal disease, is typically ameliorated through hemodialysis. The present case concerns an 84-year-old male with chronic renal failure undergoing hemodialysis, presenting involuntary movements in his limbs, which gradually worsened from the initiation of hemodialysis without constant elevation of serum blood urea nitrogen and electrolytes levels. Surface electromyography revealed characteristic findings consistent with myoclonus. He was diagnosed with subcortical-nonsegmental myoclonus related to hemodialysis, and the myoclonus was significantly alleviated after slightly increasing the post-dialysis target weight even though drug treatment was ineffective. This case suggests that drug-resistant myoclonus in patients with renal failure may be improved by adjusting hemodialysis settings, even in cases of atypical dialysis disequilibrium syndrome.
肌阵挛是终末期肾病患者的一种罕见并发症，通常通过血液透析得到改善。本病例涉及一名84岁患有慢性肾衰竭且正在接受血液透析的男性，其四肢出现不自主运动，自开始血液透析后逐渐加重，而血清血尿素氮和电解质水平并未持续升高。表面肌电图显示出与肌阵挛相符的特征性表现。他被诊断为与血液透析相关的皮质下非节段性肌阵挛，尽管药物治疗无效，但在稍微增加透析后目标体重后，肌阵挛明显缓解。该病例表明，即使在非典型透析失衡综合征的情况下，通过调整血液透析设置，肾衰竭患者的耐药性肌阵挛也可能得到改善。
