r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-6-84-88r-n-j-376Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSОстрая уремическая полиневропатия у пациентки с болезнью АльцгеймераAcute uremic polyneuropathy in a patient with Alzheimer’s diseasehttps://orcid.org/0000-0003-0461-9647МамыкинаС. А.MamykinaS. A.

Кафедра и клиника нервных болезней и нейрохирургии им. А.Я. Кожевникова

Москва

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow

sonya180197@yandex.ruhttps://orcid.org/0000-0003-1164-5667ОгановВ. В.OganovV. V.

Кафедра и клиника нервных болезней и нейрохирургии им. А.Я. Кожевникова

Москва

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow

https://orcid.org/0000-0002-7330-633XВоскресенскаяО. Н.VoskresenskayaO. N.

Кафедра и клиника нервных болезней и нейрохирургии им. А.Я. Кожевникова

Москва

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow

https://orcid.org/0000-0003-3524-3494ГринюкВ. В.GrinyukV. V.

Кафедра и клиника нервных болезней и нейрохирургии им. А.Я. Кожевникова

Москва

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow

Институт клинической медицины им. Н.В. Склифосовского ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of RussiaRussian Federation2022110120232768488Copyright © Мамыкина С.А., Оганов В.В., Воскресенская О.Н., Гринюк В.В., 20232023Мамыкина С.А., Оганов В.В., Воскресенская О.Н., Гринюк В.В.Mamykina S.A., Oganov V.V., Voskresenskaya O.N., Grinyuk V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/376

Представлен клинический случай острого развития уремической полиневропатии (УПНП). У пациентки 71 года без видимой причины остро возникла слабость в ногах и онемение в стопах. В неврологическом статусе при поступлении: периферический тетрапарез, нарушение чувствительности по полиневропатическому типу. Неврологическая симптоматика развилась на фоне лабораторно подтвержденного нарушения функции почек. При электронейромиографии выявлены признаки острой демиелинизирующей полиневропатии. У пациентки в клинике была диагностирована болезнь Альцгеймера (БА). На фоне проводимой терапии отмечалась нормализация лабораторных показателей и полное восстановление двигательных функций. Особенностью представленного клинического наблюдения является острое развитие УПНП на фоне нарушения водного режима в силу имеющихся когнитивных нарушений у пациентки с БА без анамнестических сведений о заболеваниях почек, а также полное восстановление двигательных функций в течение месяца после коррекции водно-электролитных нарушений. Обсуждаются вопросы патогенеза и дифференциального диагноза с другими видами полиневропатий.

The article presents a case of acute uremic neuropathy. Without any visible cause, a 71-year-old patient felt weakness in legs and numbness in feet. Her neurological status assessment on admission to the hospital showed peripheral tetraparesis and impaired sensitivity of the polyneuropathic type. Neurological symptoms appeared due to renal dysfunction, which had been confi rmed with laboratory test. Electroneuromyography revealed signs of acute demyelinating polyneuropathy. Аt the hospital, the patient was diagnosed Alzheimer’s disease. The treatment provided at the hospital led to normalization of her laboratory parameters and complete restoration of motor functions. The peculiarity of the presented clinical case is that the patient started violating drinking regime due to her cognitive impairment which resulted in renal dysfunction and acute uremic neuropathy. The other peculiarity of the case is that it was enough to correct the water-electrolyte disorders to fully restore the patient’s motor functions within a month, without the use of dialysis. Finally, the article discusses the issue of pathogenesis and diff erential diagnosis of other types of polyneuropathies.

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The authors declare that there are no conflicts of interest present.