DIABETIC ENCEPHALOPATHY

In the second half of the nineteenth century clinical and histological evidence of brain disease in diabetes mellitus was the subject of much discussion. One point of interest was whether cerebral changes were the cause or a sequela of the disease (Marchal (de Calvi) ( I 864) , Seegen ( 1893 ) ). Much of this literature is difficult to evaluate to-day. Very little has been published on the histology of the brain in diabetes during the last few decades, and modern textbooks either ignore the brain or state that there are no cerebral anomalies in diabetes mellitus (Warren d LeCompte (1952), J o s h (1959), Williants (1960)) . In the course of the last 10-20 years much knowledge has accumulated on vascular disease in diabetes. It is known that vascular lesions of various organs occur in most patients after they have had diabetes for many years, and there are good reasons to assume that the vascular disease of diabetics is a specific diabetic anomaly (Lundbak (1953, 1954, 1957)) . However, no detailed studies of the vessels of the brain in long-term diabctes seem to have been published. Below, a brief presentation is given of the case histories, including general autopsy findings, of three patients who had had diabetes mellitus for from 24 to 30 years, followed by a report of the neuropathological observations. The case reports are presented in the order of increasing severity of the neuropathological changes. The severe damage found on histological examination of the brains from these three patients justifies the term encephalopathy.