Teaching NeuroImage: Central Pontine Myelinolysis in Diabetic Ketoacidosis

A 38-year-old woman with uncontrolled type 1 diabetes (HbA1c 12.8%) was admitted for diabetic ketoacidosis (731 mg/dL blood glucose). Hyperglycemia was corrected within 24 hours to 129 mg/dL. Upon presentation, her sodium and potassium levels were 139 and 3.9 mmol/L, respectively, remaining stable until discharge. There was no history of malnutrition or alcohol abuse.