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June 18, 1982

Encephalopathy Following Jejunoileostomy-Reply

Author Affiliations

University of Rochester School of Medicine and Dentistry Rochester, NY

JAMA. 1982;247(23):3184. doi:10.1001/jama.1982.03320480011008

In Reply.—  The episodes of recurrent metabolic acidosis and ataxia described by Dr Catlin seem similar to the recurrent attacks noted in our case 7 and by Fuller et al1 in the two patients they described. In addition, we have received information about three other similar cases all occurring one year or more after JIB. Interestingly, two of these three patients' conditions were initially diagnosed as Meniere's disease until it became apparent that a metabolic acidosis was concomitantly present.During the repetitive episodes we observed in our case 7, different modalities of therapy were attempted. It became apparent that these were self-limited attacks. Resolution of the symptoms and amelioration of the metabolic acidosis occurred on one occasion when the patient had drunk only water for the first 12 hours. During other admissions, the syndrome resolved satisfactorily with administration of physiological saline or with 5% dextrose and water without any