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. Case report : 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.