Encephalopathy following diabetic ketoacidosis in a type 1 diabetes patient

A 44‐year‐old gentleman with type 1 diabetes mellitus was found collapsed with diabetic ketoacidosis. Following correction of the metabolic derangements his level of consciousness improved but he became encephalopathic, exhibiting unprecedented aggression with non‐specific neurological signs. This profound neurological state persisted for one month. Reversible causes of encephalopathy were investigated and excluded. The patient made a slow and almost complete recovery over a period of six months.

Encephalopathy is an unusual complication of hyperglycaemic emergencies with poorly understood underlying mechanisms. This case demonstrates the importance of considering and treating the numerous reversible causes of an encephalopathic state before attributing altered levels of consciousness to the acute metabolic disturbances only. Copyright © 2010 John Wiley & Sons.