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Dialysis Patient. Body Moves In Nonrhythmic Involuntary Way, Cannot Swallow, Has Rashes, High BP. Remedy Of The Condition?

Posted on Fri, 6 Jul 2012

Question: Hi,my mother ,67 yrs old,is a dialysis patient.she has to do it twice per week.for last two and half month she is suffering from an uncommon physical movement.her whole body moves in a nonrythmic involuntery way for all the time when she is awake.but whenever she gets asleep the movement remains no more.then it starts as soon as she is not in sleep.nowdays(for last 15 days)she doesnot want to take anything to eat.this symtom has started since one month but now it has increased very much. she cannot get up or sit or stand by herself.it has been a great problem to feed her or give her medicines.she doesn't want to swallow anything.it seems that she can't get the instuction from her brain.the result is that she lacs nutrition.she doesn'n speak clearly.In last November she was admitted in hospital for breathing trouble.after returning home we saw that she didn't talk..she was suffering from pain in the backside of her neck.in this condition she was sent to a neurologist who gave her SERTA tablet.but she didn't recover,then she went to a neurologist who prescribed her ROPARK and AMANTREL.after this medication the movement of whole body started.then my mother was given PRAMIPEX by the doctor.but the result was that her whole body got plenty of rashes,irritation and burn like injury.she couldn't recover from that movement too.now she is taking PACITANE100 till date.but of no result.as I told you that she is a Dialysis patient,she takes some medicines regularly,named-STAMLO 5,MINIPRESS XL5,APRESOL25,ARKAMIN100,DYTOR100,THYRONORM100,ALPHA D3,OMEZ(OMEZ has been stopped for last few days).SHE IS A HIGH BLOOD PRESSURE PATIENT.I want to know the cause and the remedy of this condition my mother is suffering from a lot.

Answered by Dr. Shiva Kumar R (1 hour later)

Hello

Thanks for the query

From the information provided to me it looks like she is suffering from a condition called as choreoathetosis. Chronic renal failure and haemodialysis patients are prone to develop encephalopathy of unclear cause. Whenever a structure called basal ganglia is involved in the brain, abnormal movements arise such as chorea and athetosis arise. Rarely disease of the cerebellum which co-ordinates movements can cause speech problems and ataxia which can mimic chorea.

A good physical examination from the Neurologist would differentiate chorea from ataxia. MRI of the brain will indicate if there is involvement of the basal ganglia and the cerebellum. Thiamine deficiency in people undergoing dialysis can also present with similar problems.

Medications like Haloperidol and pimozide will benefit choreoathetosis. Pacitaine, pramipex, amantrel and ropark are not the primary drugs used in the treatment of chorea.

So I personally advise you to see a good Neurologist for a good clinical examination and syndromic diagnosis. In addition to encephalopathy, condition like Stroke can be diagnosed on the MRI of the brain. Depending on the findings on the imaging further investigations can be planned.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar