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Aphasic status epilepticus complicating hyperosmolar hyperglycaemic state.

Omar Bokhari1, Sarah Alqhtani2,3, Laila Alqahtani4

  • 1Department of Medicine (Neurology), Dalhousie University, Halifax, Nova Scotia, Canada.

Practical Neurology
|December 4, 2025
PubMed
Summary
This summary is machine-generated.

Hyperosmolar hyperglycaemic state, a diabetic emergency, can cause aphasic status epilepticus, a rare language disorder. Prompt treatment with insulin and antiseizure drugs can lead to significant recovery.

Keywords:
DIABETES MELLITUSEPILEPSY

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Area of Science:

  • Neurology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Aphasic status epilepticus (ASE) is a rare neurological complication of hyperosmolar hyperglycaemic state (HHS).
  • HHS is a severe metabolic emergency in diabetes mellitus, characterized by hyperglycemia and dehydration.
  • ASE presents as language disturbance with preserved consciousness, complicating diagnosis.

Purpose of the Study:

  • To describe a case of aphasic status epilepticus secondary to hyperosmolar hyperglycaemic state.
  • To highlight the neurological manifestations of uncontrolled diabetes.
  • To review the literature on this under-recognized clinical entity.

Main Methods:

  • Case report of a 66-year-old man with type 2 diabetes presenting with speech decline.
  • Electroencephalogram (EEG) to confirm non-convulsive status epilepticus.
  • Magnetic Resonance (MR) brain imaging to assess neurological changes.

Main Results:

  • The patient exhibited progressive speech decline and impaired coordination.
  • EEG confirmed non-convulsive status epilepticus.
  • MR imaging revealed transient left temporal changes and later hippocampal atrophy.
  • Treatment with insulin and levetiracetam resulted in significant recovery.

Conclusions:

  • Hyperosmolar hyperglycaemic states are a reversible cause of aphasic status epilepticus.
  • Uncontrolled diabetes can present with diverse neurological symptoms.
  • Early diagnosis and management are crucial for favorable outcomes in ASE related to HHS.