Medulloblastoma presenting as dialysis disequilibrium syndrome

Dialysis disequilibrium syndrome (DDS) is a central nervous system disorder that occurs during or after hemodialysis. This is caused by brain edema that manifests as neurological symptoms that include headache, emesis, nausea, blurring of vision, disturbed consciousness, tremors and seizures, and in severe cases, death. The incidence of DDS is very high among patients with preexisting neurological diseases. There has been much debate about the origin of DDS. We report a case of DDS, as presenting syndrome of a medulloblastoma in a child aged 5 years, and discuss the pathogenesis and the possible role of DDS for an earlier detection of occult brain lesions in dialyzed patients.