Initial manifestation of type I diabetes mellitus as an unusual cause of early post-operative seizures.
We present a case of an 18-year-old patient who underwent resective epilepsy surgery for intractable epilepsy caused by focal cortical dysplasia. In the early post-surgical period, the patient started experiencing atypical seizures refractory to antiepileptic treatment. In due course, abnormally low levels of blood sodium and extremely high levels of blood glucose were discovered. Significant hyperglycaemia was initially ascribed to steroid-induced diabetes, and antibodies specific to type I diabetes mellitus were subsequently detected, confirming the diagnosis. Following stabilization of glucose and electrolyte levels, the patient became seizure-free. To our knowledge, this is the first report of presentation of type I diabetes as the cause of early post-operative seizures. We discuss less common aetiologies of seizures in the early post-operative period, including metabolic disturbances. Based on our experience, we stress the importance of electrolyte and glucose monitoring in the setting of acute post-operative seizures.
Department of Paediatric Neurology.
Barbora
B
Benova
Department of Paediatric Neurology.
Pavel
P
Krsek
Department of Paediatrics.
Zdenek
Z
Sumnik
Department of Paediatric Neurology.
Martin
M
Kudr
Department of Paediatric Neurology.
Vladimir
V
Komarek
Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
Michal
M
Tichy
D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D000069279:Drug Resistant Epilepsy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000601:surgery*; D019635:Neurosurgical Procedures; D011183:Postoperative Complications; D011184:Postoperative Period; D012640:Seizures / Q000209:etiology*
acute post-operative seizure; epilepsy surgery; focal cortical dysplasia; intractable epilepsy; type I diabetes mellitus