Pleocytosis and Meningeal Signs in Uremia

Abstract

attacks of uremia with as high as 20 lymphocytes per cubic millimeter of spinal fluid during each episode, cell counts were made in 62 consecutive cases of uremia. Patients with a history or findings of syphilis or with any condition that could result in pleocytosis were not included in the series. In the last 30 cases examination was also made for the presence of meningeal signs. In 58 of the 62 cases the uremia was due to renal disorders and in 4 to gastric hemorrhages with prerenal azotemia. The urea content of the blood was calculated from the urea nitrogen determined by the aeration-titration method. The urea value of the cerebrospinal fluid was similarly determined from specimens drawn at the same time as the blood in 29 cases.An increase in cells in the spinal fluid has been mentioned in isolated instances of uremia by various investigators. Chauffard 1 reported the case of a woman aged 60 with renal disease of three months' duration with uremia. Spinal puncture revealed 50 segmented granulocytes (polymorphonuclear leukocytes) per microscopic field in the fluid on the first day of the illness. Eight days later there were between 6 and 7 cells, and 28 days later, no cells. Lepine 2 found no increase of cells in the spinal fluid in 3 cases of uremia in which such data were given. The meninges were intensely reddened. Lepine stated the belief that the meninges in uremia could be involved in the same manner as the peri¬ cardium. Caussade and Willette 3 described a case of uremia with 100

Clinical Aspects of Uraemic Polyneuropathy

“…Coefficient o f correlation: 0.42. 16 patients with grade 2 neuropathy had had a high urea level for more than 5 months. The chance of developing polyneuropathy increased as the urea level had been longer above 200 mg/100 ml.…”

Neurological Aspects of Dialysis Patients

“…The urea concentration is similar to that in serum. Pleocytosis has been reported previously but not in recent publications (8)(9)(10)(11). Electro-encephalographic (EEG) changes develop concurrently with the clinical disorder and include disorganisation, slowing and loss of alpha…”

Neurological Aspects of Dialysis Patients

“…The CSF urea concentration is similar to that in serum. Pleocytosis has been reported previously but not in more recent publications (11)(12)(13)(14). Electroencephalographic (EEG) changes develop concurrently with the clinical disorder and include disorganisation, slowing and loss of alpha frequency, diffuse slow wave bursts and specific paroxysmal discharges (15,16).…”