Multiple Cerebral Haematomata and Peripheral Nerve Palsies Associated with a Case of Juvenile Diabetic Ketoacidosis

Stephen Atkin, A. M. Coady, D. Horton, N. Sutaria, L. Sellars, C. Walton

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

A 15‐year‐old girl presented de novo in diabetic ketoacidosis having been comatose for 24 h (day 1). A CT scan and lumbar puncture performed on admission were normal and her conscious level slowly improved over several days. On day 7 she had central neurological signs of bilateral knee clonus and an extensor plantar response. In addition, she had developed lower motor neurological signs of an ulnar nerve palsy of the left forearm, and ulnar, median, and radial nerve palsies of the right forearm. Magnetic resonance imaging (MRI), performed on day 12, showed multiple small cerebral haematomata with appearances at least several days of age. The scattered lesions were localized particularly to the parieto‐occipital region, with sparing of the basal ganglia and without cerebral oedema, a novel feature not previously described in juvenile ketoacidosis. Four months later there was minimal residual disability of her right arm. The clinical findings together with the MRI images suggested that the peripheral nerve and central lesions were temporally related, suggesting a common aetiology. However, it is likely that MRI showed cerebral lesions which may have been missed by the conventional CT scanning performed initially. 1995 Diabetes UK

Original languageEnglish
Pages (from-to)267-270
Number of pages4
JournalDiabetic Medicine
Volume12
Issue number3
DOIs
Publication statusPublished - 1995
Externally publishedYes

Fingerprint

Diabetic Ketoacidosis
Peripheral Nerves
Paralysis
Hematoma
Magnetic Resonance Imaging
Forearm
Babinski's Reflex
Ulnar Neuropathies
Radial Nerve
Ketosis
Ulnar Nerve
Spinal Puncture
Median Nerve
Brain Edema
Coma
Basal Ganglia
Knee
Arm

Keywords

  • Cerebral haemorrhage
  • Diabetes mellitus
  • Diabetic ketoacidosis
  • Peripheral neuropathy
  • Renal failure

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Multiple Cerebral Haematomata and Peripheral Nerve Palsies Associated with a Case of Juvenile Diabetic Ketoacidosis. / Atkin, Stephen; Coady, A. M.; Horton, D.; Sutaria, N.; Sellars, L.; Walton, C.

In: Diabetic Medicine, Vol. 12, No. 3, 1995, p. 267-270.

Research output: Contribution to journalArticle

Atkin, Stephen ; Coady, A. M. ; Horton, D. ; Sutaria, N. ; Sellars, L. ; Walton, C. / Multiple Cerebral Haematomata and Peripheral Nerve Palsies Associated with a Case of Juvenile Diabetic Ketoacidosis. In: Diabetic Medicine. 1995 ; Vol. 12, No. 3. pp. 267-270.
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