Hyperglycemia presenting with occipital seizures.
Seizures are common in hyperglycemia and are often the first manifestation, particularly in nonketotic hyperglycemia (NKH). Published reports emphasize partial motor seizures almost exclusively. In a 3-year period, we observed three patients in whom occipital seizures, documented by ictal EEG recording, were the initial symptom of hyperglycemia. One patient was mildly ketotic at first. Seizures were visual in two patients and visual and adversive in the third. Seizures regressed with correction of abnormal glucose levels and did not recur during follow-up of less than or equal to 1 year despite discontinuation of antiepileptic drugs (AEDs) in two. Computed tomography (CT) scans did not show correlative abnormalities. Although published reports suggest that frontal lobe structures are particularly susceptible to the epileptogenic effects of NKH, our experience indicates that in NKH epileptic foci may originate in other cortical areas, such as occipital.
Harden
C L
CL
Department of Neurology, New York Medical College/Metropolitan Hospital, NY 10029.
Rosenbaum
D H
DH
Daras
M
M
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012640:Seizures / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants