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Brain infarction in children with diabetic ketoacidosis
T F Roe1, T O Crawford, K R Huff
1Department of Pediatrics, University of Southern California School of Medicine, Los Angeles, USA.
Insights
Brain infarction, not just cerebral edema, causes persistent neurologic loss in children with diabetic ketoacidosis (DKA). This finding highlights the need for careful diagnosis in pediatric DKA cases.
Area of Science:
- Pediatric Neurology
- Endocrinology
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes in children.
- Neurologic complications during DKA can be severe and persistent.
- Cerebral edema is a known, but not the only, cause of neurologic decline in DKA.
Abstract:
During the last 10 years, five children were treated at Childrens Hospital Los Angeles for acute, persistent neurologic loss during diabetic ketoacidosis (DKA). Four were transferred from local hospitals after the neurologic crisis. Computed tomography (CT) studies showed one or more areas of brain infarction in each patient, and none had evidence of diffuse cerebral edema. As three of the five patients had been treated for cerebral edema before their CT, brain edema may have been present initially. Our findings emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.