Seizures can be a potential complication of DKA/HHS.

Seizures can be a potential complication of DKA/HHS.

• A. Hypercalcemia
• B. Hypoglycemia
• C. Seizures
• D. Hypertension

Answer: (C)

Seizures in DKA/HHS come from brain irritation caused by major fluid and electrolyte disturbances. The extreme hyperglycemia drives osmotic shifts that dilute serum sodium, leading to hyponatremia, which lowers the seizure threshold. In addition, when treatment rapidly corrects hyperglycemia or sodium, osmolality can shift quickly and provoke cerebral edema, a scenario especially noted in children, and that edema can present with seizures. Because of these osmotic and electrolyte dynamics, seizures are a recognized complication of these diabetic emergencies. While other choices like hypercalcemia or hypertension aren’t typical direct complications of DKA/HHS, and hypoglycemia is more of a treatment-associated risk than a primary presentation, the seizure risk tied to electrolyte/osmotic disturbances best explains why seizures occur in this setting.

Seizures in DKA/HHS come from brain irritation caused by major fluid and electrolyte disturbances. The extreme hyperglycemia drives osmotic shifts that dilute serum sodium, leading to hyponatremia, which lowers the seizure threshold. In addition, when treatment rapidly corrects hyperglycemia or sodium, osmolality can shift quickly and provoke cerebral edema, a scenario especially noted in children, and that edema can present with seizures. Because of these osmotic and electrolyte dynamics, seizures are a recognized complication of these diabetic emergencies. While other choices like hypercalcemia or hypertension aren’t typical direct complications of DKA/HHS, and hypoglycemia is more of a treatment-associated risk than a primary presentation, the seizure risk tied to electrolyte/osmotic disturbances best explains why seizures occur in this setting.