Uremic encephalopathy

Case contributed by Dr Dalia Ibrahim

Presentation

Vomiting, seizures, and abnormal movements of both upper limbs.

Patient Data

Age: 35 years

Bilateral abnormal increased signal of both basal ganglia.

Bilateral cheek subcutaneous injectable fillers (Incidental finding).

Case Discussion

Upon further questioning the patient, she mentioned she had chronic renal failure on dialysis which was inadequately treated during the last period.

Basal ganglia T2 hyperintensity

A variety of causes might cause basal ganglia high T2 signal like:

In case of uremic encephalopathy: lentiform fork sign: is a characteristic feature of uremic encephalopathy, in which the white matter surrounding the basal ganglia (the internal and external capsules and the medullary laminae) becomes hyperintense on T2/FLAIR

It's important to have detailed clinical and labratory data in case of high T2 basal ganglia signal in order to reach the correct diagnosis.

 

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