OSMOTIC DEMYELINATION SYNDROME WITH A DISEQUILIBRIUM SYNDROME - REVERSIBLE MRI FINDINGS

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.