[Progressive dialytic encephalopathy. Role of the aluminium and neurological study. One case (author's transl)]. / Encéphalopathie progressive des dialysés: rôle de l'aluminium et étude neuropathologique. Une observation.

Report a typical case of dialytic dementia in a patient treated with aluminium gels. The course was fatal in fifteen months duration. Before interruption of aluminium gel intake, the aluminium blood level measured by atomic absorption spectrography was at 1300 microgram/l (normal less than 40 microgram/l). Cerebral aluminium was studied by the method of Le Gendre and Alfrey. On the three studied specimens of gray matter including, the parieto rolandic cortex, the thalamus, the cerebellar cortex, the mean aluminium concentration was seven times higher than the witness. The optic and electronic microscopy study showed important accumulation of lipofuscin. No neurofibrillary degeneration was observed. In contrast to the intensity of the clinical signs and the fatal course the cerebral lesions were slight.

[Prolonged and reversible encephalopathy in a chronic haemodialysis patient. Probable responsibility of aluminium salts (author's transl)]. / Encéphalopathie prolongée et réversible chez un dialysé chronique. Responsabilité probable des sels d'aluminium.

A case of encephalopathy with elevation of plasma aluminium level in a patient treated by maintenance hemodialysis is reported. Clinical symptoms were made of moderate impairment of intellectual functions and of intermittent drowsiness. EEG after 3 minutes of hyperpnea evidenced bisynchronous anteriorly dominant intermittent delta waves. Plasma aluminium level, determined by atomic absorption spectrophotometry, was initially at 300 microgram/l (normal range greater than 40 microgram/l). After interruption of aluminium gels, clinical and EEG symptoms slowly subsided in 9 months, plasma aluminium level came down to 145 microgram/l. This picture of encephalopathy could preceede irreversible dialysis dementia in chronic dialysis patients.