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Acute hemiparesis in juvenile insulin-dependent diabetes mellitus (JIDDM)
Abstract:
Four episodes of acute left hemiparesis occurred in three pediatric-age, insulin-dependent diabetic patients. Each had a concomitant respiratory tract infection and headache, but no obvious signs of systemic hypoglycemia. No cerebral abnormalities were demonstrated by angiography or computerized tomography. The clinical course was benign, with slow but complete resolution of neurologic abnormalities within 8 to 24 hours of onset, and no further neurologic complaints in a 7- to 16-month follow-up.
Insights
Pediatric patients with diabetes experienced temporary left-sided weakness during infections. Symptoms resolved fully within 24 hours, indicating a benign, non-stroke related neurological event.
Area of Science:
- Neurology
- Pediatrics
- Endocrinology
Background:
- Insulin-dependent diabetes mellitus (IDDM) in pediatric patients presents unique clinical challenges.
- Neurological complications in diabetic children require careful differentiation from other causes.
Observation:
- Three pediatric patients with IDDM experienced four episodes of acute left hemiparesis.
- Episodes coincided with respiratory tract infections and headaches, without overt signs of hypoglycemia.
- Cerebral imaging (angiography, CT scans) revealed no abnormalities.
Findings:
- The hemiparetic episodes in these diabetic children were transient and self-limiting.
- Neurological deficits resolved completely within 8 to 24 hours.
- No recurrence or long-term sequelae were noted during 7- to 16-month follow-up.
Implications:
- This suggests a potential link between infections and transient neurological events in pediatric diabetes.
- It highlights the importance of considering non-stroke neurological events in diabetic children presenting with hemiparesis.
- Further research may elucidate the underlying pathophysiology and diagnostic markers.