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Neuro


- Discussion:
    - decrease phenothiazines (reversible Parkinson's dz);
    - may find defects in mentation, neuritis of myelinated long nerves (restless leg syndrome), and MS changes;
    - uremic polyneuropathy, w/ decr electric conduction along myelinated nerve fibers;
    - conduction may be as low as 15 to 20/sec in renal failure;
    - progression to symmetric distal neuropathy, starting at toes & working up leg occurs in 5-10% of uremic pts, usually those who are not on dialysis;
    - autonomic insufficiency in uremia as a component of generalized neuropathy may present as hypotension during dialysis or as a neurogenic bladder;
    - seizures:
         - due to uremia, hyponatremia, acidosis, hyperosmolality, hypoCa, and meningitis;
         - due to HTN, subarachnoid hemorrhage, CVA, systemic emboli, hypogly
         - steroid psychosis, drug toxicity, and drug withdrawl