Desferrioxamine infusion can modify EEG tracing haemodialysed patients

D. Brancaccio, G. Avanzini, P. Padovese, M. Gallieni, S. Franceschetti, F. Panzica, A. Anelli, G. Colantonio, D. Martinelli, O. Bugiani

Research output: Contribution to journalArticlepeer-review

Abstract

Neurological derangement has been reported in haemodialysed patients receiving intravenous desferrioxamine (DFO) for aluminium-related disorders. The possible direct effects of desferrioxamine on EEG recordings were investigated in ten haemodialysed patients who underwent a DFO test 2 h after the end of dialysis. According to a commonly accepted protocol, 40 mg/kg body-weight of desferrioxamine was infused in 60 min. EEG recording was continuously performed, starting 30 min before and stopping 30 min after the desferrioxamine infusion. Besides visual inspection, EEG records were digitised, tapered, and spectrally analysed with Digital PDP 11/73 microcomputer. Basal EEG recording was normal in all patients. In three patients a progressive EEG slowing was detected by visual inspection during desferrioxamine infusion; in these cases automatic analysis revealed a 50% increase in power of slower frequencies 30 min after starting the infusion, when no changes in plasma aluminium concentrations are detected; a complete recovery was observed 30 min after desferrioxamine withdrawal. In one patient bilateral paroxysms of slow waves appeared, so we stopped desferrioxamine infusion. Two of the three patients who developed EEG abnormalities also had an increased aluminium body burden (positive DFO test). Results indicated that desferrioxamine per se can modify EEG in haemodialysis patients and that its effect is not mediated by acute increases of plasma aluminium concentrations. The finding of a positive DFO test in two of three patients with EEG changes may suggest that an aluminium-induced blood-brain barrier derangement could have played a role. However, prompt recovery after ceasing desferrioxamine infusion strongly suggests a direct role of desferrioxamine in the induction of EEG changes. These findings contribute to a better understanding of the acute impairment in neurological status when high doses of desferrioxamine are infused in haemodialysis patients with aluminium overload.

Original languageEnglish
Pages (from-to)264-268
Number of pages5
JournalNephrology Dialysis Transplantation
Volume6
Issue number4
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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