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Hyperglycemic hemianopia: A case report.

Xiao-Hui Xiang1, Jia-Jia Fang1, Mi Yang1

  • 1Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China.

World Journal of Clinical Cases
|March 17, 2021
PubMed
Summary
This summary is machine-generated.

Nonketotic hyperglycemia (NKH) can cause visual disturbances like homonymous hemianopia. Prompt treatment with rehydration and insulin can improve these neurological symptoms.

Keywords:
Case reportHomonymous hemianopiaImaging manifestationsNonketotic hyperglycemiaOccipital seizures

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Area of Science:

  • Neurology
  • Endocrinology
  • Ophthalmology

Background:

  • Nonketotic hyperglycemia (NKH) presents with high blood sugar and minimal ketoacidosis.
  • Neurological symptoms in NKH patients are diverse, ranging from movement disorders to seizures and coma.
  • Homonymous hemianopia due to hyperglycemia is an underrecognized neurological manifestation.

Observation:

  • A 54-year-old man experienced visual disturbances, including seeing flickering lights and right homonymous hemianopia.
  • Cranial MRI revealed abnormalities in the left occipital lobe, including white matter signal changes and restricted diffusion.

Findings:

  • The patient's homonymous hemianopia improved after rehydration and low-dose insulin therapy.
  • MRI findings correlated with the observed visual field defect.

Implications:

  • NKH can manifest with focal neurological signs, including visual field deficits.
  • Hyperglycemia should be considered in the differential diagnosis of homonymous hemianopia.
  • Early recognition and management of hyperglycemia are crucial for resolving neurological symptoms.