A rare presentiation of uremia: akathisia

Acute movement disorders associated with bilateral basal ganglia lesions are becoming more common in patients with diabetes and uremia. Pathophysiology is not fully known, although it is believed to be complex, with ischemic/microvascular as well as metabolic/toxic variables influencing lesions and symptoms. We have reported here a uremic diabetic patient who has sudden developed severe akathisia, in magnetic resonance imaging (MRI) showed bilateral symmetric basal ganglia lesions with regression at follow-up. A condition linked with acute bilateral basal ganglia lesions in diabetic uremic individuals is uncommon, with clinical and imaging data demonstrating reversible alterations. Akathisia secondary to uremia is rarely seen in the literature. Our goal is to improve awareness of this condition among doctors and radiologists in order to identify more cases.