Table 1—

Bedside evaluation of neurological state of children with DKA

Diagnostic criteria
 Abnormal motor or verbal response to pain
 Decorticate or decerebrate posture
 Cranial nerve palsy (especially III, IV, and VI)
 Abnormal neurogenic respiratory pattern (e.g., grunting, tachypnea, Cheyne-Stokes respiration, apneusis)
Major criteria
 Altered mentation/fluctuating level of consciousness
 Sustained heart rate deceleration (decline more than 20 bpm) not attributable to improved intravascular volume or sleep state
 Age-inappropriate incontinence
Minor criteria
 Vomiting
 Headache
 Lethargy or being not easily aroused from sleep
 Diastolic blood pressure >90 mmHg
 Age <5 years
  • Signs that occur before treatment should not be considered in the diagnosis of cerebral edema.