Neurological disorders may be seen in end-stage renal disease patients
due to uraemia or to complications of dialysis. A dysequilibrium synd
rome may be seen, usually soon after or towards the end of haemodialys
is. This group of patients has no particular findings on MRI. On the o
ther hand, the osmotic demyelination syndrome has definitive MRI findi
ngs, not to date reported with the dysequilibrium syndrome. We report
a patient with end-stage renal disease and the dysequilibrium syndrome
who showed findings of osmotic demyelination on MRI. The patient had
a convulsion after a first haemodialysis, with quadriparesis and hyper
active deep tendon reflexes and bilateral Babinski signs. The upper mo
tor neurone signs lasted for a week. Meanwhile, he was also dysarthric
and had dysphagia. He recovered neurologically without any residuum f
ollowing appropriate treatment and there was improvement on MRI.