A Case of Hyperglycemia-Induced Epileptic Homonymous Hemianopsia.
| Autor: | Shiraishi W; Department of Neurology, Kokura Memorial Hospital, Kitakyushu, JPN.; Department of Internal Medicine, Shiraishi Internal Medicine Clinic, Nogata, JPN., Inamori Y; Department of Neurology, Kokura Memorial Hospital, Kitakyushu, JPN., Nakazawa Y; Department of Neurorlogy, Kokura Memorial Hospital, Kitakyushu, JPN., Shii H; Department of Neurology, Kitakyushu Yahata Higashi Hospital, Kitakyushu, JPN. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Jul 22; Vol. 16 (7), pp. e65102. Date of Electronic Publication: 2024 Jul 22 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.65102 |
| Abstrakt: | Hyperglycemia sometimes initially presents with neurological manifestations, including seizures, visual hallucinations, choreoathetosis, hemiballismus, myoclonus, tremor, and consciousness disturbance. Epileptic seizures induced by hyperglycemia are reported to occur predominantly in the occipital lobe, and the epileptic form is mainly epilepsia partialis continua. Of the two patterns of hyperglycemia (ketotic or nonketotic), nonketotic hyperglycemia is more commonly associated with seizures because ketosis has an anticonvulsive effect, so hyperglycemia-induced seizures are generally seen in nonketotic patients. Here, we report a 51-year-old Japanese male with intermittent homonymous hemianopsia who presented high hemoglobin A1c (19.1%). He had been drinking 3 L of the sugared soft beverage every day. After admission, he showed left-sided hemiconvulsion. Anti-seizure medications and insulin treatment were administered, and his seizure was aborted. The magnetic resonance imaging (MRI) showed a high-intensity lesion in the diffusion-weighted image and fluid-attenuated inversion recovery with gadolinium enhancement in the occipital lobe. In hyperglycemic convulsions, MRI sometimes shows leptomeningeal or parenchymal gadolinium enhancement. In addition, most hyperglycemic seizures are associated with nonketotic hyperglycemia and show occipital-dominant imaging abnormalities. We report this case by reviewing the differential diagnosis. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Shiraishi et al.) |
| Databáze: | MEDLINE |
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