Reversible tetraplegia due to polyneuropathy in a diabetic patient with hyperosmolar non-ketotic coma

Intensive Care Med. 1999 Dec;25(12):1437-9. doi: 10.1007/s001340051095.


Critical illness polyneuromypathy has not previously been reported as a complication of diabetic coma. We describe a patient with hyperosmolar non-ketotic coma (HONK) complicating gram-negative sepsis in whom persistent coma and profound tetraplegia caused considerable concern. Although, initially, it was feared that the patient had suffered a central neurological complication such as stroke or cerebral oedema, a diagnosis of critical illness motor syndrome (CIMS) was subsequently confirmed neurophysiologically. Profound limb weakness associated with HONK is not necessarily due to a catastrophic cerebral event, rather it may be a result of CIMS, which has an excellent prognosis for full neurological recovery.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Critical Illness
  • Diabetic Neuropathies / etiology*
  • Escherichia coli Infections / complications*
  • Female
  • Humans
  • Hyperglycemic Hyperosmolar Nonketotic Coma / complications*
  • Quadriplegia / etiology*
  • Sepsis / complications*
  • Syndrome