Metabolic encephalopathy secondary to diabetic ketoacidosis: a case report

• DOI: 10.1186/s12902-019-0398-8
• Publication Date: 2019-07-02T12:03:18Z
• Authors: Maria Tomkins; Richard McCormack; Karen O’Connell; Amar Agha; Áine Merwick
• Keywords: Diabetic ketoacidosis; Ketoacidosis; Cognitive Decline

Metabolic encephalopathy is a rare but potentially devastating complication of diabetic ketoacidosis (DKA). This case highlights the dramatic cognitive decline young man due to metabolic complicating DKA. The aims this report are highlight as DKA and explore current research in related brain injury. importance investigation treatment reversible causes also demonstrated.A 35-year-old with background type 1 diabetes mellitus (T1DM) relapsing remitting multiple sclerosis (RRMS) presented emergency department (ED) confused agitated state. Prior admission he worked caretaker school, smoked ten cigarettes per day, took excess alcohol cannabis twice week. Following initial investigations, was found be Despite timely appropriate management his neurological symptoms behavioural disturbance persisted. Neuroimaging revealed temporal lobe abnormalities consistent an encephalopathic process. patient underwent extensive looking for evidence autoimmune, infective, metabolic, toxic paraneoplastic encephalopathy, no obvious cause demonstrated. Due persistent radiological biopsy performed which showed marked astrocytic gliosis without vasculitis, inflammation, infarction or neoplasia. A diagnosis secondary reached. patient's function remained impaired up 18 months post presentation ultimately required residential care.Metabolic has been associated acute insults such DKA, importantly, risk cerebral injury chronic hyperglycaemia. Mechanisms continue investigated. poses serious significant patients mellitus. To our knowledge second describing complication.