title: [Visual episodes in non-ketonic hyperglycemia: contribution of 1 case with alteration in diffusion magnetic resonance imaging].
abstract: BACKGROUND
  Non-ketonic hyperglycemia (NKH) is recognized both as a direct cause of a precipitating factor of many types of epileptic seizures-partial motor, including partial motor status, complex partial, as well as reflex motor seizures and hemichorea-hemibalism syndrome. Less known is its association with isolated visual alterations. We present a clinical case with visual episodes and diffusion restriction.
  
  
  METHODS
  Clinical description together with the results of complementary tests: magnetic resonance imaging (MRI) brain sequences: T1W, T2W, FLAIR, DP, diffusion; and magnetic resonance angio-imaging, electroencephalogram (EEG), visual campimetry, carotid echodoppler.
  
  
  METHODS
  51 year old male with visual complaints manifested as bright light in left lower quadrant with progressive increase in frequency until it becomes constant. Polyuria, polydipsia and weight loss are associated. No personal background of diabetes mellitus, epilepsy or migraine. Among the laboratory tests, non-ketonic hyperglycemia of 569 mg/dl stands out. The visual campimetry showed left lower quadrantanopsia, the intercritical EEG was reported as normal and the brain MRI showed alteration in right cortical-subcortical occipital diffusion sequence. Interpreted as simple partial seizure in the occipital region secondary to hyperglycemia, it was corrected, and the subject was asymptomatic at one month of discharge.
  
  
  CONCLUSIONS
  We stress that isolated visual episodes may be the initial manifestation of NKH. The rareness of the alteration in the diffussion MRI (interpretable as artifact) orients to a possible mechanism of simple partial status. A high index of suspicion of this entity is important since adequate hypoglycemic treatment permits a perfect control of the seizure.
authors.affiliation: Servicio de Neurología, Hospital General Castellon, Spain. teresa.perez@uv.es
authors.forename: T
authors.initials: T
authors.lastname: Pérez Saldaña M
authors.forename: D
authors.initials: D
authors.lastname: Geffner
authors.forename: C
authors.initials: C
authors.lastname: Vilar Fabra
authors.forename: I
authors.initials: I
authors.lastname: Martínez Bernat
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging; D004827:Epilepsy / Q000209:etiology; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology*