Neurological Manifestations in Patients Presenting with Uremic Encephalopathy at a Tertiary Care Hospital

Abstract

Objective:  To assess the neurological presentation in patients with uremic encephalopathy and its correlation with the severity of the disease at a tertiary care centre and to find out its prevalence.

Materials & Methods:  This is an observational cross-sectional study that was carried out at Lady Reading Hospital, Peshawar. The patients were sampled consecutively, giving a total of 230 patients with uremic encephalopathy. Neurological evaluation was carried out using clinical examination, laboratory, and selected neurophysiology tests. The associations were tested by chi-square and t-tests.

Results:  The most frequent neurological manifestations were altered consciousness (77.4 percent), followed by confusion (67 percent) and asterixis (38.2 percent). Of all cases, 26.9 per cent had seizures. Renal failure (stage 4 and above) was highly correlated with severe neurological dysfunction (p-value < 0.001). The most common EEG abnormalities were diffuse slowing and triphasic waves. Of the patients, 45.2 per cent had a complete recovery after dialysis, with 6.9 per cent dying.**

Conclusion:  Neurological signs and symptoms in uremic encephalopathy were common and were closely associated with the degree of renal failure. Early diagnosis and prompt dialysis were correlated with a better neurological outcome.