Metabolic Encephalopathy in Diabetic Ketoacidosis (DKA)

Patient selection: diabetic ketoacidosis with neurologic findings

Clinical findings may include:

(1) seizures

(2) ataxia

(3) altered level of consciousness

(4) posterior reversible encephalopathy syndrome (PRES)

(5) movement disorder

Factors contributing to encephalopathy:

(1) thiamine deficiency in alcoholics (Wernicke encephalopathy)

(2) chronic hypo or hyperglycemia

(3) severe hypophosphatemia

CT or MRI changes may show focal changes affecting various parts of the brain.

The diagnosis requires exclusion of other causes such as cerebral edema and infectious encephalitis.