Diabetic ketoacidosis (DKA) may rarely be associated with a range of metabolic disturbances that can be categorized as metabolic encephalopathies. These are often reversible once the metabolic causes have been corrected.

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.

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