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Diabetic ketoacidosis and electroencephalographic changes in newly diagnosed pediatric patients
Author(s) -
Mackay Mark T,
Molesworth Charlotte,
Northam Elisabeth A,
Inder Terrie E,
Cameron Fergus J
Publication year - 2016
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12284
Subject(s) - medicine , diabetic ketoacidosis , encephalopathy , pediatrics , electroencephalography , prospective cohort study , diabetes mellitus , type 1 diabetes , cohort , anesthesia , psychiatry , endocrinology
Objective To document electroencephalogram ( EEG ) changes and their correlation with clinical parameters in a newly diagnosed pediatric cohort of type 1 diabetes mellitus ( T1DM ) patients with and without diabetic ketoacidosis ( DKA ) and to define their medium term utility and significance. Research design and methods Prospective longitudinal study of children presenting with T1DM . EEGs were performed within 24 h of diagnosis, day 5, and at 6 months post‐diagnosis and reviewed by a neurologist blinded to clinical status. Severity of encephalopathy was graded from 1 to 5 using the Aoki and Lombroso encephalopathy scale. Cognitive abilities were assessed using standardized tests of attention, memory, and intelligence. Results Eighty eight children were recruited; 34 presented with DKA . Abnormal background slowing was more often observed in the first 24 h in children with DKA (p = 0.01). Encephalopathy scores on day 1 correlated with initial pH , CO 2 , HCO 3 , base excess, respiratory rate, heart rate, diastolic blood pressure, and IV fluid intake (all parameters p < 0.05). EEG scores at day 1 did not correlate with contemporaneous mental state or cognition in the medium term. Conclusions DKA was associated with significant clinical and neurophysiologic signs of brain dysfunction at presentation. While EEG is sensitive to the detection of encephalopathy in newly diagnosed T1DM , it has limited use in identifying children at risk of later cognitive deficits.