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Hyperglycemia presenting with occipital seizures.

C L Harden¹, D H Rosenbaum, M Daras

¹Department of Neurology, New York Medical College/Metropolitan Hospital, NY 10029.

|March 1, 1991

Summary

Seizures can be an early sign of hyperglycemia, especially nonketotic hyperglycemia (NKH). Occipital seizures, often visual, were observed as the initial symptom in three patients, challenging prior assumptions about NKH

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Area of Science:

Neurology
Endocrinology

Background:

Seizures are a known complication of hyperglycemia.
Nonketotic hyperglycemia (NKH) typically presents with partial motor seizures, often implicating frontal lobe structures.

Observation:

Three patients presented with occipital seizures as the initial manifestation of hyperglycemia.
Seizures were documented by ictal electroencephalogram (EEG) recording.
Seizure semiology included visual disturbances and adversive components.

Findings:

Occipital epileptic foci can be an initial presentation of nonketotic hyperglycemia.
Seizures resolved with correction of hyperglycemia.
No correlative abnormalities were found on computed tomography (CT) scans.

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Implications:

This challenges the traditional view that NKH-related seizures exclusively involve frontal lobe structures.
Occipital lobe epilepsy should be considered in the differential diagnosis of new-onset seizures associated with hyperglycemia.
Further research is needed to understand the full spectrum of cortical involvement in NKH-induced seizures.