Scientific article
Case report

Encéphalopathie complexe, transitoire et récidivante après résection étendue de l'intestin grêle. Responsabilité du D-Lactate

Published inRevue neurologique, vol. 157, no. 6-7, p. 679-681
Publication date2001

Recurrent episodes of confusion are most commonly due to transient brain dysfunction related to vascular, epileptic or metabolic abnormalities. We report here a 54-year-old patient who, in the months following an extensive surgery of the small intestine, developed several acute confusional episodes characterized by encephalopathic signs (such as behavioral changes, desorientation and somnolence), ataxia, nystagmus and dysarthria. A number of metabolic changes were demonstrated during the episodes, including metabolic acidosis with increased anion gap and an elevated blood level of D-lactate. Symptoms disappeared after treatment with antibiotics. D-lactate encephalopathy is a rare cause of recurrent confusion which could be suspected based on a characteristic association of clinical signs. Diagnosis is confirmed by appropriate dosages. We discussed the possible mechanisms leading to confusional episodes.

  • Acidosis, Lactic/blood/diagnosis
  • Brain Diseases, Metabolic/blood/diagnosis
  • Confusion/blood/diagnosis
  • Humans
  • Intestine, Small/blood supply/surgery
  • Ischemia/surgery
  • Lactic Acid/blood
  • Male
  • Mesenteric Artery, Superior/surgery
  • Mesenteric Vascular Occlusion/surgery
  • Middle Aged
  • Neurologic Examination
  • Postoperative Complications/blood/diagnosis
  • Recurrence
  • Risk Factors
  • Short Bowel Syndrome/blood/diagnosis
  • Thrombosis/surgery
Citation (ISO format)
LALIVE D’EPINAY, Patrice et al. Encéphalopathie complexe, transitoire et récidivante après résection étendue de l’intestin grêle. Responsabilité du D-Lactate. In: Revue neurologique, 2001, vol. 157, n° 6-7, p. 679–681.
ISSN of the journal0035-3787

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