Acta Neurol Taiwan. 2017 Jun 15;26(2):64-67.

  • 55y/o, ESRD due to T2DM for several years,
  • ER, newly developed resting tremor of bilateral upper limbs for 5 days followed by slowness of movements, small shuffling steps, drooling and mask face
  • Brain CT: hypodense change over bilateral basal ganglion and acute ischemic stroke was initially suspected
  • Brain MRI: symmetric swelling and hyperintensity on T2-weighted image over bilateral lentiform nuclei with restricted diffusion on diffusion weighted imaging
    (DWI), which indicated demyelinating change
  • Diagnosis: ODS
  • Ropirinole 0.25 mg bid
  • Symptoms improved by 2 weeks
  • Ropirinole tapered
  • Brain MRI: resolution