Hyperglycemia-induced isolated aphasic status epilepticus a case-report and literature review

Neurological manifestations of nonketotic hyperglycemia are frequently seen, with mainly symptoms of confusion or coma. While hyperglycemia-induced seizures are less common, isolated aphasic status epilepticus is very rare, difficult to diagnose, and may be unrecognized by clinicians. In this case report, a 51-year-old man who presented with confusion and incoherent speech for two weeks is discussed. He was diagnosed with nonketotic hyperglycemia, whose electroencephalography (EEG) findings were suggestive of isolated aphasic status epilepticus. His magnetic resonance imaging (MRI) of the brain showed subcortical T2/FLAIR hypointense lesions with cortical T2/FLAIR hyperintensities and restricted diffusion. Although this condition usually responds well to intensive insulin therapy and fluid replacement, many researchers found some persistent aphasic seizures that did not improve until the addition of anti-seizure medications (ASMs).