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Neurological Dysfunction Associated With Nonketotic Hyperglycemia

Neurological Dysfunction Associated With Nonketotic Hyperglycemia Abstract THE RAPIDLY accumulating literature on nonketotic hyperglycemia attests to increased interest in this entity.1-48 The metabolic abnormalities that define the syn drome have been delineated (Table 1). The necessity for its early recognition and prompt treatment with large quantities of hypotonic fluids and insulin is well established. In contrast, the extent to which neurological dysfunction can result from this metabolic imbalance is not commonly recognized. The fact that some of these patients can present with overt, focal neurological signs44 is denied21,40 or minimized.35 Some interpret their early appearance as evidence that "strokes" are an etiological factor in the development of nonketotic hyperglycemia.7,48 To others the appearance of focal neurological deficit in the course of the illness signifies the occurrence of "strokes" and such a possibility is listed as a cause of death.36 Finally, these patients are often simply misdiagnosed as cerebrovascular accidents presenting References 1. Wegierko, J.: Typical Syndrome of Clinical Symptoms in the Diabetic Patient Ending With Death in Coma Without Ketotic Acidemia "Third Coma," Pol Tyg Lek 11:2020-2023 ( (Nov 26) ) 1956. 2. Sament, S., and Schwartz, M.B.: Severe Diabetic Stupor With Ketosis , S Afr Med J 31:893-894 ( (Sept 7) ) 1957. 3. Zierler, K.L.: Hyperosmolality in Adults: A Critical Review , J Chron Dis 7:1-23 ( (Jan) ) 1958.Crossref 4. DeGraeff, J.: Les troubles electrolytiques dans le coma diabetique , Bruxelles Med 36:1153-1179 ( (Sept 13) ) 1959. 5. Lexow, P.: Diabetic Coma Without Ketosis , Acta Med Scand 163:115-119 ( (Feb 25) ) 1959.Crossref 6. Ober, W.B.: Hyperglycemia and Hyperpyrexia: Clinicopathological Conference , New York J Med 60:2885-2896 ( (Sept 15) ) 1960. 7. Stötter, G.: Comptes rendus du 4e Congres de la Federation Internationale du Diabete , Geneve, 1961, pp 565-567. 8. Iyengar, M.O.P.: Extreme Hyperglycemia Without Ketosis , Lancet 2:664-665 ( (Sept) ) 1961.Crossref 9. Rossier, P.H.; Reutter, F.; and Frick, P.: Das Hyperosmolare nicht acidotische Koma bei Diabetes Mellitus , Deutsch Med Wschr 86:2145-2148 ( (Nov) ) 1961.Crossref 10. Von Rechenberg, H.K.: Das Hyperosmolare, nicht acidotische diabetische Koma , Schweiz Med Wschr 92:1415-1416 ( (Nov) ) 1962. 11. With, T.K.: Atypical Diabetic Coma: Severe Hyperglycemia Without Acidosis , Nord Med 68:971 ( (Aug) ) 1962. 12. Lucas, C.P., et al: Diabetic Coma Without Ketoacidosis , Lancet 1:175-177 ( (Jan) ) 1963. 13. Reutter, F., and Rossier, P.H.: Hyperosmolares, nicht-acidotisches Koma bei Diabetes Mellitus , Schweiz Med Wschr 93:1007-1008 ( (July 20) ) 1963. 14. Jackson, W.P.U.: Diabetic Coma Without Ketoacidosis , Lancet 1:394 ( (Feb 16) ) 1963.Crossref 15. Ward, F.G.: Diabetic Coma Without Ketoacidosis , Lancet 1:450-452 ( (Feb 23) ) 1963.Crossref 16. Azerad, E., and Lubetzki, J.: Les comas par hyperglycemie et hyperosmolarite sans acidocetose chez le diabetique , Presse Med 71:261-264 ( (Feb) ) 1963. 17. Larcan, A., et al: Comas metaboliques non acidocetosiques chez des diabetiques , Diabete 11:99-101 ( (Feb) ) 1963. 18. Boulet, P., et al: Hyperglycemie et coma sans acilo-cetose chez les diabetiques , Diabete 11:325-329 ( (Dec) ) 1963. 19. Jarrett, E., and Bacon, G.: Hyperosmolality and Diabetic Coma , Lancet 1:891 ( (April 20) ) 1963.Crossref 20. Mach, R.S., and DeSousa, R.C.: Coma avec hyperosmolarite et deshydratation chez des malades hyperglycemiques sans acidocetose , Schweiz Med Wschr 93:1256-1263 ( (Sept 7) ) 1963. 21. Guillon, J., et al: Reflexions sur les comas hyperosmolaries chez les diabetiques , J Med Nantes 4:59-96 ( (Jan-March) ) 1964. 22. Brugi, A., and Brambilla, R.: Varieta rare di coma diabetico , Atti Accad Med Lombard 19:359-361 ( (Aug-Dec) ) 1964. 23. Nicholson, W.A., et al: Diabetic Coma Without Ketoacidosis , Lancet 1:982 ( (May 2) ) 1964.Crossref 24. Durr, F.: Beitrag zum hyperosmolaren nichtacidotischen koma bei Diabetes Mellitus , Deutsch Med Wschr 89:76-81 ( (Jan 10) ) 1964.Crossref 25. Davidson, A.I.G.: Diabetic Coma Without Ketoacidosis in a Patient With Acute Pancreatitis , Brit Med J 1:356 ( (Feb 8) ) 1964.Crossref 26. Barrelet, J.A., and Menetry, C.: Coma hyperglycemique, hyperosmolaire sans acidose chez le diabetique , Rev Med Suisse Rom 84:633-641 ( (Sept) ) 1964. 27. Gigon, J.P.: Le coma hyperosmolaire non acidocetosique chez le diabetique , Path Biol 12:1191-1202 ( (Dec) ) 1964. 28. Panzram, G., and Pense, G.: Coma diabeticum ohne ketoazidose , Z Ges Inn Med 19:698-702 ( (Sept 1) ) 1964. 29. Dura, J.: Non Acidotic Hyperosmolar Coma in Diabetics , Cas Lek Cesk 103:337-339 ( (March 27) ) 1964. 30. Bergoz, R., and Hausser, E.: Diabetic Coma Without Ketoacidosis , Lancet 1:116 ( (Jan 11) ) 1964.Crossref 31. Rosner, K., and Neuendorf, W.: Das hyperosmolare diabetische koma ohne ketoacidose , Z Ges Inn Med 19:271-274 ( (March 15) ) 1964. 32. Kasperska, T.: Osmotic Coma in Diabetes , Pol Tyg Lek 19:2016-2017 ( (Dec 26) ) 1964. 33. Hansen, E.: Severe Diabetic Coma Without Ketoacidosis , Ugeskr Laeg 126:1097-1102 ( (Aug 6) ) 1964. 34. Brocard, H.; Akoun, G.; and Grand, A.: Diabete steroide complique d'un coma de type hyperosmolaire , Bull Soc Med Hop Paris 116:353-363 ( (Feb 5) ) 1965. 35. DiBenedetto, R.J.; Crocco, J.A.; and Soscia, J.E.: Hyperglycemic Nonketotic Coma , Arch Intern Med 116:74-82 ( (July) ) 1965.Crossref 36. Danowski, T.S., and Nabarro, J.D.N.: Hyperosmolar and Other Types of Nonketoacidotic Coma in Diabetes , Diabetes 14:162-165 ( (March) ) 1965. 37. Beck, H.: A Special Complication of Diabetes , Rev Franc Geront 11:107-108 ( (April) ) 1965. 38. Rosenberg, S.A., et al: The Syndrome of Dehydration, Coma and Hyperglycemia Without Ketosis in Patients Convalescing From Burns , New Eng J Med 272:931-938 ( (May 6) ) 1965.Crossref 39. Diabetic Coma Without Ketoacidosis , editorial, Brit Med J 2:1016 ( (Oct 30) ) 1965.Crossref 40. Lubetzki, J.: Les comas diabetiques hyperosmolaires , Coeur Med Intern 4:497-505 ( (Oct) ) 1965. 41. Pariente, R., et al: Coma diabetique avec hyperosmolarite sans acidocetose associe a une pancreatite aigue necrosante , Bull Soc Med Hop Paris 116:897-906 ( (May 28) ) 1965. 42. Pavel, I., et al: Coma diabetica hiperosmolara fara acidocetoza , Stud Cercet Med Intern 6:145-155, 1965. 43. Bacanu, G., et al: Coma diabetica hiperosmolara fara acidocetoza , Med Intern 17:353-359 ( (March) ) 1965. 44. Maccario, M.; Messis, C.P.; Vastola, E.F.: Focal Seizures as a Manifestation of Hyperglycemia Without Ketoacidosis , Neurology 15:195-206 ( (March) ) 1965.Crossref 45. Chlebowski, J.: Atypical Diabetic Coma: Two Case Reports , Wiad Lek 18:425-427, 1965. 46. Ciba, T.; Wojcikiewicz, O.; and Dubiel, J.: Hyperosmolar Diabetic Coma , Wiad Lek 18:949-952 ( (June 1) ) 1965. 47. Halmos, P.B.; Nelson, J.K.; and Lowry, R.C.: Hyperosmolar Non-Ketoacidotic Coma in Diabetes , Lancet 1:675-679 ( (March 26) ) 1966.Crossref 48. Matz, R., and Drapkin, A.: Hyperosmolar Coma in Diabetes , Lancet 1:1101 ( (May 14) ) 1966.Crossref 49. Wierzuchowski, M.: Overflow Diabetes and Toxic Phenomena Due to the Infusion of Glucose in Normal Dogs , J Physiol 87:85, 1936. 50. Winkler, A.W., et al: Experimental Hypertonicity: Alterations in the Distribution of Body Water and the Cause of Death , J Clin Invest 23:103-109 ( (Jan) ) 1944.Crossref 51. Finberg, L.; Luttrell, C.; and Redd, H.: Pathogenesis of Lesions in the Nervous System in Hypernatremic States: II. Experimental Studies of Gross Anatomic Changes and Alteration of Chemical Composition of the Tissues , Pediatrics 23:46-53 ( (Jan) ) 1959. 52. Sotos, J.F., et al: Studies in Experimental Hypertonicity: 1. Pathogenesis of the Clinical Syndrome, Biochemical Abnormalities and Cause of Death , Pediatrics 26:925-938 ( (Dec) ) 1960. 53. Dodge, P.R., et al: Neurophysiologic Disturbances in Hypertonic Dehydration , Trans Amer Neurol Assoc 87:33-36, 1962. 54. DeLeon, A., and Bergstrom, W.H.: Hypertonic Dehydration , New York J Med 64:2157-2160 ( (Sept 1) ) 1964. 55. Vastola, E.F.; Maccario, M.; and Homan, R.: Activation of Epileptogenic Foci by Hyperosmolality , Neurology 17:521-526 ( (May) ) 1967.Crossref 56. Pineda, A., and Adey, W.R.: Effects of Hypertonic Urea on the Evoked Potential of the Cerebral and Cerebellar Cortices in Cats , Trans Amer Neurol Assoc 90:276-277, 1965. 57. Geiger, A., et al: Effect of Blood Constituents on Uptake of Glucose and on Metabolic Rate of the Brain in Perfusion Experiments , Amer J Physiol 177:138-148 ( (April) ) 1954. 58. Gilbert, J.C.: Mechanisms of Sugar Transport in Brain Slices , Nature 205:87-88 ( (Jan 2) ) 1965.Crossref 59. Gilbert, J.C.: Characteristics of Sugar Transportation System in Brain Tissues , Fed Proc 24:326, 1965. 60. Wright, H.K., and Gann, D.S.: Hyperglycemia Hyponatremia in Nondiabetic Patients , Arch Intern Med 112:344-346 ( (Sept) ) 1963.Crossref 61. Pillay, V.K.G.: Neurological Manifestations of Diabetic Ketosis , S Afr Med J 38:128-129 ( (Feb 15) ) 1964. 62. Logothetis, J., and Baker, A.B.: Neurological Manifestations in Diabetes Mellitus , Med Clin N Amer 47:1459-1466 ( (Nov) ) 1963. 63. Fazekas, J.F., and Alman, R.W.: Coma , Springfield, Ill: Charles C Thomas, Publishers, 1962, p 45. 64. Brodsky, W.; Rapaport, S.; and West, C.: Mechanism of Glycosuria Diuresis in Diabetic Man , J Clin Invest 29:1021-1032 ( (Aug) ) 1950.Crossref 65. Potter, D.J.: Death as a Result of Hyperglycemia Without Ketosis: A Complication of Hemodialysis , Ann Intern Med 64:399-401 ( (Feb) ) 1966.Crossref 66. Hamberger, A., and Lovtrup, S.: The Effect of Brain Dehydration on the Activity of Respiratory Enzymes in Isolated Neurons, Neuroglial Cells and in Brain Mitochondria , J Neurochem 11:687-694 ( (Sept) ) 1964.Crossref 67. Agnew, W.F.: Effects of Plasma Tonicity on the Distribution of Water and Solutes in Brain and Muscle , Exp Neurol 13:58-70 ( (Sept) ) 1965.Crossref 68. Luse, S.A., and Harris, B.: Brain Ultrastructure in Hydration and Dehydration , Arch Neurol 4:139-152 ( (Feb) ) 1961.Crossref 69. Shenkin, H.A., and Finneson, B.E.: Clinical Significance of Low Cerebral Spinal Fluid Pressure , Neurology 8:157-163 ( (March) ) 1958.Crossref 70. Crighel, E., and Tudor, I.: Quelques donnees experimentales sur le mecanisme de facilitation de la post decharge epileptiforme du neocortex , Rev Neurol 108:180-181 ( (Feb) ) 1963. 71. Williams, D.: The Thalamus and Epilepsy , Brain 88:539, 1965.Crossref 72. Faris, A.A., and Poser, C.M.: Experimental Production of Focal Neurologic Deficit by Systemic Hyponatremia , Neurology 14:206-211 ( (March) ) 1964.Crossref 73. Portnoy, H.D.: Transient "Ischemic" Attacks Produced by Carotid Stenosis and Hypoglycemia , Neurology 15:830-832 ( (Sept) ) 1965.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Neurological Dysfunction Associated With Nonketotic Hyperglycemia

Archives of Neurology , Volume 19 (5) – Nov 1, 1968

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References (72)

Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1968.00480050095009
Publisher site
See Article on Publisher Site

Abstract

Abstract THE RAPIDLY accumulating literature on nonketotic hyperglycemia attests to increased interest in this entity.1-48 The metabolic abnormalities that define the syn drome have been delineated (Table 1). The necessity for its early recognition and prompt treatment with large quantities of hypotonic fluids and insulin is well established. In contrast, the extent to which neurological dysfunction can result from this metabolic imbalance is not commonly recognized. The fact that some of these patients can present with overt, focal neurological signs44 is denied21,40 or minimized.35 Some interpret their early appearance as evidence that "strokes" are an etiological factor in the development of nonketotic hyperglycemia.7,48 To others the appearance of focal neurological deficit in the course of the illness signifies the occurrence of "strokes" and such a possibility is listed as a cause of death.36 Finally, these patients are often simply misdiagnosed as cerebrovascular accidents presenting References 1. Wegierko, J.: Typical Syndrome of Clinical Symptoms in the Diabetic Patient Ending With Death in Coma Without Ketotic Acidemia "Third Coma," Pol Tyg Lek 11:2020-2023 ( (Nov 26) ) 1956. 2. Sament, S., and Schwartz, M.B.: Severe Diabetic Stupor With Ketosis , S Afr Med J 31:893-894 ( (Sept 7) ) 1957. 3. Zierler, K.L.: Hyperosmolality in Adults: A Critical Review , J Chron Dis 7:1-23 ( (Jan) ) 1958.Crossref 4. DeGraeff, J.: Les troubles electrolytiques dans le coma diabetique , Bruxelles Med 36:1153-1179 ( (Sept 13) ) 1959. 5. Lexow, P.: Diabetic Coma Without Ketosis , Acta Med Scand 163:115-119 ( (Feb 25) ) 1959.Crossref 6. Ober, W.B.: Hyperglycemia and Hyperpyrexia: Clinicopathological Conference , New York J Med 60:2885-2896 ( (Sept 15) ) 1960. 7. Stötter, G.: Comptes rendus du 4e Congres de la Federation Internationale du Diabete , Geneve, 1961, pp 565-567. 8. Iyengar, M.O.P.: Extreme Hyperglycemia Without Ketosis , Lancet 2:664-665 ( (Sept) ) 1961.Crossref 9. Rossier, P.H.; Reutter, F.; and Frick, P.: Das Hyperosmolare nicht acidotische Koma bei Diabetes Mellitus , Deutsch Med Wschr 86:2145-2148 ( (Nov) ) 1961.Crossref 10. Von Rechenberg, H.K.: Das Hyperosmolare, nicht acidotische diabetische Koma , Schweiz Med Wschr 92:1415-1416 ( (Nov) ) 1962. 11. With, T.K.: Atypical Diabetic Coma: Severe Hyperglycemia Without Acidosis , Nord Med 68:971 ( (Aug) ) 1962. 12. Lucas, C.P., et al: Diabetic Coma Without Ketoacidosis , Lancet 1:175-177 ( (Jan) ) 1963. 13. Reutter, F., and Rossier, P.H.: Hyperosmolares, nicht-acidotisches Koma bei Diabetes Mellitus , Schweiz Med Wschr 93:1007-1008 ( (July 20) ) 1963. 14. Jackson, W.P.U.: Diabetic Coma Without Ketoacidosis , Lancet 1:394 ( (Feb 16) ) 1963.Crossref 15. Ward, F.G.: Diabetic Coma Without Ketoacidosis , Lancet 1:450-452 ( (Feb 23) ) 1963.Crossref 16. Azerad, E., and Lubetzki, J.: Les comas par hyperglycemie et hyperosmolarite sans acidocetose chez le diabetique , Presse Med 71:261-264 ( (Feb) ) 1963. 17. Larcan, A., et al: Comas metaboliques non acidocetosiques chez des diabetiques , Diabete 11:99-101 ( (Feb) ) 1963. 18. Boulet, P., et al: Hyperglycemie et coma sans acilo-cetose chez les diabetiques , Diabete 11:325-329 ( (Dec) ) 1963. 19. Jarrett, E., and Bacon, G.: Hyperosmolality and Diabetic Coma , Lancet 1:891 ( (April 20) ) 1963.Crossref 20. Mach, R.S., and DeSousa, R.C.: Coma avec hyperosmolarite et deshydratation chez des malades hyperglycemiques sans acidocetose , Schweiz Med Wschr 93:1256-1263 ( (Sept 7) ) 1963. 21. Guillon, J., et al: Reflexions sur les comas hyperosmolaries chez les diabetiques , J Med Nantes 4:59-96 ( (Jan-March) ) 1964. 22. Brugi, A., and Brambilla, R.: Varieta rare di coma diabetico , Atti Accad Med Lombard 19:359-361 ( (Aug-Dec) ) 1964. 23. Nicholson, W.A., et al: Diabetic Coma Without Ketoacidosis , Lancet 1:982 ( (May 2) ) 1964.Crossref 24. Durr, F.: Beitrag zum hyperosmolaren nichtacidotischen koma bei Diabetes Mellitus , Deutsch Med Wschr 89:76-81 ( (Jan 10) ) 1964.Crossref 25. Davidson, A.I.G.: Diabetic Coma Without Ketoacidosis in a Patient With Acute Pancreatitis , Brit Med J 1:356 ( (Feb 8) ) 1964.Crossref 26. Barrelet, J.A., and Menetry, C.: Coma hyperglycemique, hyperosmolaire sans acidose chez le diabetique , Rev Med Suisse Rom 84:633-641 ( (Sept) ) 1964. 27. Gigon, J.P.: Le coma hyperosmolaire non acidocetosique chez le diabetique , Path Biol 12:1191-1202 ( (Dec) ) 1964. 28. Panzram, G., and Pense, G.: Coma diabeticum ohne ketoazidose , Z Ges Inn Med 19:698-702 ( (Sept 1) ) 1964. 29. Dura, J.: Non Acidotic Hyperosmolar Coma in Diabetics , Cas Lek Cesk 103:337-339 ( (March 27) ) 1964. 30. Bergoz, R., and Hausser, E.: Diabetic Coma Without Ketoacidosis , Lancet 1:116 ( (Jan 11) ) 1964.Crossref 31. Rosner, K., and Neuendorf, W.: Das hyperosmolare diabetische koma ohne ketoacidose , Z Ges Inn Med 19:271-274 ( (March 15) ) 1964. 32. Kasperska, T.: Osmotic Coma in Diabetes , Pol Tyg Lek 19:2016-2017 ( (Dec 26) ) 1964. 33. Hansen, E.: Severe Diabetic Coma Without Ketoacidosis , Ugeskr Laeg 126:1097-1102 ( (Aug 6) ) 1964. 34. Brocard, H.; Akoun, G.; and Grand, A.: Diabete steroide complique d'un coma de type hyperosmolaire , Bull Soc Med Hop Paris 116:353-363 ( (Feb 5) ) 1965. 35. DiBenedetto, R.J.; Crocco, J.A.; and Soscia, J.E.: Hyperglycemic Nonketotic Coma , Arch Intern Med 116:74-82 ( (July) ) 1965.Crossref 36. Danowski, T.S., and Nabarro, J.D.N.: Hyperosmolar and Other Types of Nonketoacidotic Coma in Diabetes , Diabetes 14:162-165 ( (March) ) 1965. 37. Beck, H.: A Special Complication of Diabetes , Rev Franc Geront 11:107-108 ( (April) ) 1965. 38. Rosenberg, S.A., et al: The Syndrome of Dehydration, Coma and Hyperglycemia Without Ketosis in Patients Convalescing From Burns , New Eng J Med 272:931-938 ( (May 6) ) 1965.Crossref 39. Diabetic Coma Without Ketoacidosis , editorial, Brit Med J 2:1016 ( (Oct 30) ) 1965.Crossref 40. Lubetzki, J.: Les comas diabetiques hyperosmolaires , Coeur Med Intern 4:497-505 ( (Oct) ) 1965. 41. Pariente, R., et al: Coma diabetique avec hyperosmolarite sans acidocetose associe a une pancreatite aigue necrosante , Bull Soc Med Hop Paris 116:897-906 ( (May 28) ) 1965. 42. Pavel, I., et al: Coma diabetica hiperosmolara fara acidocetoza , Stud Cercet Med Intern 6:145-155, 1965. 43. Bacanu, G., et al: Coma diabetica hiperosmolara fara acidocetoza , Med Intern 17:353-359 ( (March) ) 1965. 44. Maccario, M.; Messis, C.P.; Vastola, E.F.: Focal Seizures as a Manifestation of Hyperglycemia Without Ketoacidosis , Neurology 15:195-206 ( (March) ) 1965.Crossref 45. Chlebowski, J.: Atypical Diabetic Coma: Two Case Reports , Wiad Lek 18:425-427, 1965. 46. Ciba, T.; Wojcikiewicz, O.; and Dubiel, J.: Hyperosmolar Diabetic Coma , Wiad Lek 18:949-952 ( (June 1) ) 1965. 47. Halmos, P.B.; Nelson, J.K.; and Lowry, R.C.: Hyperosmolar Non-Ketoacidotic Coma in Diabetes , Lancet 1:675-679 ( (March 26) ) 1966.Crossref 48. Matz, R., and Drapkin, A.: Hyperosmolar Coma in Diabetes , Lancet 1:1101 ( (May 14) ) 1966.Crossref 49. Wierzuchowski, M.: Overflow Diabetes and Toxic Phenomena Due to the Infusion of Glucose in Normal Dogs , J Physiol 87:85, 1936. 50. Winkler, A.W., et al: Experimental Hypertonicity: Alterations in the Distribution of Body Water and the Cause of Death , J Clin Invest 23:103-109 ( (Jan) ) 1944.Crossref 51. Finberg, L.; Luttrell, C.; and Redd, H.: Pathogenesis of Lesions in the Nervous System in Hypernatremic States: II. Experimental Studies of Gross Anatomic Changes and Alteration of Chemical Composition of the Tissues , Pediatrics 23:46-53 ( (Jan) ) 1959. 52. Sotos, J.F., et al: Studies in Experimental Hypertonicity: 1. Pathogenesis of the Clinical Syndrome, Biochemical Abnormalities and Cause of Death , Pediatrics 26:925-938 ( (Dec) ) 1960. 53. Dodge, P.R., et al: Neurophysiologic Disturbances in Hypertonic Dehydration , Trans Amer Neurol Assoc 87:33-36, 1962. 54. DeLeon, A., and Bergstrom, W.H.: Hypertonic Dehydration , New York J Med 64:2157-2160 ( (Sept 1) ) 1964. 55. Vastola, E.F.; Maccario, M.; and Homan, R.: Activation of Epileptogenic Foci by Hyperosmolality , Neurology 17:521-526 ( (May) ) 1967.Crossref 56. Pineda, A., and Adey, W.R.: Effects of Hypertonic Urea on the Evoked Potential of the Cerebral and Cerebellar Cortices in Cats , Trans Amer Neurol Assoc 90:276-277, 1965. 57. Geiger, A., et al: Effect of Blood Constituents on Uptake of Glucose and on Metabolic Rate of the Brain in Perfusion Experiments , Amer J Physiol 177:138-148 ( (April) ) 1954. 58. Gilbert, J.C.: Mechanisms of Sugar Transport in Brain Slices , Nature 205:87-88 ( (Jan 2) ) 1965.Crossref 59. Gilbert, J.C.: Characteristics of Sugar Transportation System in Brain Tissues , Fed Proc 24:326, 1965. 60. Wright, H.K., and Gann, D.S.: Hyperglycemia Hyponatremia in Nondiabetic Patients , Arch Intern Med 112:344-346 ( (Sept) ) 1963.Crossref 61. Pillay, V.K.G.: Neurological Manifestations of Diabetic Ketosis , S Afr Med J 38:128-129 ( (Feb 15) ) 1964. 62. Logothetis, J., and Baker, A.B.: Neurological Manifestations in Diabetes Mellitus , Med Clin N Amer 47:1459-1466 ( (Nov) ) 1963. 63. Fazekas, J.F., and Alman, R.W.: Coma , Springfield, Ill: Charles C Thomas, Publishers, 1962, p 45. 64. Brodsky, W.; Rapaport, S.; and West, C.: Mechanism of Glycosuria Diuresis in Diabetic Man , J Clin Invest 29:1021-1032 ( (Aug) ) 1950.Crossref 65. Potter, D.J.: Death as a Result of Hyperglycemia Without Ketosis: A Complication of Hemodialysis , Ann Intern Med 64:399-401 ( (Feb) ) 1966.Crossref 66. Hamberger, A., and Lovtrup, S.: The Effect of Brain Dehydration on the Activity of Respiratory Enzymes in Isolated Neurons, Neuroglial Cells and in Brain Mitochondria , J Neurochem 11:687-694 ( (Sept) ) 1964.Crossref 67. Agnew, W.F.: Effects of Plasma Tonicity on the Distribution of Water and Solutes in Brain and Muscle , Exp Neurol 13:58-70 ( (Sept) ) 1965.Crossref 68. Luse, S.A., and Harris, B.: Brain Ultrastructure in Hydration and Dehydration , Arch Neurol 4:139-152 ( (Feb) ) 1961.Crossref 69. Shenkin, H.A., and Finneson, B.E.: Clinical Significance of Low Cerebral Spinal Fluid Pressure , Neurology 8:157-163 ( (March) ) 1958.Crossref 70. Crighel, E., and Tudor, I.: Quelques donnees experimentales sur le mecanisme de facilitation de la post decharge epileptiforme du neocortex , Rev Neurol 108:180-181 ( (Feb) ) 1963. 71. Williams, D.: The Thalamus and Epilepsy , Brain 88:539, 1965.Crossref 72. Faris, A.A., and Poser, C.M.: Experimental Production of Focal Neurologic Deficit by Systemic Hyponatremia , Neurology 14:206-211 ( (March) ) 1964.Crossref 73. Portnoy, H.D.: Transient "Ischemic" Attacks Produced by Carotid Stenosis and Hypoglycemia , Neurology 15:830-832 ( (Sept) ) 1965.Crossref

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Archives of NeurologyAmerican Medical Association

Published: Nov 1, 1968

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