Many cases are fatal and preceded by a viral upper respiratory infection. It may to be related to aspirin use. There is micro-vesicular fatty change with mitochondrial injury in the liver, and there is elevated NH3, bilirubin, and aminotransferase levels. Treatment is plasmaphoresis and exchange transfusion for liver failure, and mannitol infusion to decrease intracranial pressure. This is an Axonal Neuropathy due to degeneration of distal axons and probably results from disordered glucose metabolism.
Diabetes also produces a neuropathy due to microangiopathy.
Hypoglycemia produces a hypoxic encephalopathy identical to that produced by ischemia. Accelerated Atherosclerosis produces a higher incidence of cerebral infarction. The CNS is not affected due to the blood brain barrier, except for exposed areas like the choroid plexus and pineal gland. Subacute Combined Degeneration of the spinal cord Results from B12 deficiency, and is associated with long standing Pernicious Anemia. There is a secondary degeneration of axons with reactive gliosis.