Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.
Department of Diabetes, Gloucestershire Royal Hospital, Gloucester, UK.
Pediatr Diabetes. 2017 Mar;18(2):159-162. doi: 10.1111/pedi.12362. Epub 2016 Jan 14.
Development of acute neurological symptoms secondary to cerebral oedema is well described in diabetic ketoacidosis (DKA) and often has a poor prognosis. We present the clinical and radiological data of a 17-yr-old girl who developed cortical blindness, progressive encephalopathy, and seizures caused by posterior reversible encephalopathy syndrome (PRES) that developed after her DKA had resolved. Vasogenic oedema in PRES resolves if the underlying trigger is identified and eliminated. In this case, hypertension was identified as the likely precipitating factor and following treatment her vision and neurological symptoms rapidly improved. We suggest how recent DKA may have contributed to the development of PRES in this patient.
糖尿病酮症酸中毒(DKA)中常可描述继发于脑水肿的急性神经系统症状,且预后往往较差。我们报告了一例 17 岁女孩的临床和影像学数据,其在 DKA 缓解后发生了由后部可逆性脑病综合征(PRES)引起的皮质盲、进行性脑病和癫痫发作。如果确定并消除了潜在的触发因素,PRES 的血管源性水肿会得到缓解。在这种情况下,高血压被认为是可能的诱发因素,经过治疗,她的视力和神经症状迅速改善。我们提出了近期的 DKA 如何导致该患者 PRES 发生的可能性。