Non-ketotic hyperglycaemia presenting as epilepsia partialis continua.
Epilepsia partialis continua is a rare epileptic syndrome observed in patients with brain structural lesions and metabolic disorders. We report a patient with non-ketotic hyperglycaemia presenting as epilepsia partialis continua with reversible focal brain lesions. An 83-year-old woman visited our hospital due to sudden and repetitive left facial twitching lasting for two days. Initial laboratory data revealed serum glucose, osmolality, and sodium levels of 631 mg/dl, 310 mOsm/l, and 130 mEq/l, respectively. EEG was normal. Brain MRI showed low signal changes in the right frontal subcortical area and high signal changes in the surrounding right frontal cortical areas on T2-weighted, fluid-attenuated inversion recovery, and diffusion-weighted images. No seizures recurred after correcting blood glucose levels, hydrating the patient, and infusing valproate (900 mg/day). Follow-up MRI, six months later, showed complete resolution of the signal changes in the right frontal cortical and subcortical areas and no clinical seizures. When considering non-ketotic hyperglycaemia with epilepsia partialis continua in an elderly patient, early diagnosis and administration of the appropriate therapy is very important in order to decrease morbidity.
School of Medicine, Kyung Hee University, Neurology, Seoul, Republic of Korea.
Kyoung Jin
KJ
Hwang
School of Medicine, Kyung Hee University, Neurology, Seoul, Republic of Korea.
SungSang
S
Yoon
School of Medicine, Kyung Hee University, Neurology, Seoul, Republic of Korea.
Key-Chung
KC
Park
D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D004569:Electroencephalography; D017036:Epilepsia Partialis Continua / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D020158:Hyperglycinemia, Nonketotic / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging
brain magnetic resonance imaging; epilepsia partialis continua; non-ketotic hyperglycemia