Diabetic ketoacidosis with cerebral hemorrhage and alpha coma in an adolescent female.

BACKGROUND

Diabetic ketoacidosis (DKA) is one of the most common and harmful complications of type 1 diabetes in children. The neurologic morbidities, including seizure activity, motor/sensory deficit, and coma, can be seen secondary to cerebral edema, hemorrhage, or ischemia. Alpha-frequency is a normal 8-13 Hz physiologic electroencephalogram rhythm that is seen most prominently in the occipital region of awake people and is augmented by eye closure. In the comatose patient, alpha-rhythm is not usually seen. Alpha-frequency coma (AC) is a rare finding in comatose patients and is generally associated with a poor prognosis.

METHODS

We report an adolescent with severe DKA, intraparenchymal cerebral hemorrhage, and AC, who had a rapid resolution of the neurologic symptoms.

CONCLUSIONS

Similar to other reported cases, our case suggests that the prognosis for patients with AC may not be always poor when it is associated with DKA.