由高血糖引起的尾叶发作
Emily Resisi1, John Zadran2, Daniel Kurtz2
1Department of Medicine, New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY 11545, USA.
JCEM case reports
|October 2, 2025
概括
非基性高血糖症 (NKH) 是2型糖尿病的一种并发症,可以引发罕见的叶发作,呈现为视觉障碍. 早期识别和治疗高血糖是管理这些发作至关重要的.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 超大胞性高血糖状态 (HHS) 和非性高血糖症 (NKH) 是2型糖尿病的严重并发症.
- 带有视觉症状的尾叶发作很少见,并且往往被诊断不足.
- 失控的糖尿病会导致神经系统并发症.
研究的目的:
- 报告一个由非基性高血糖症引发的头发作病例.
- 突出诊断线索和管理这种罕见的呈现.
- 强调认识到高血糖是发作的潜在原因的重要性.
主要方法:
- 一个70岁的男性患有不受控制的2型糖尿病的案例介绍.
- 诊断工作包括实验室测试 (HbA1c,血清度),脑部MRI和脑电图 (EEG).
- 治疗包括抗药物 (莱维他) 和胰岛素治疗.
主要成果:
- 患者出现视觉现象和视野缺陷,原因是左部发作焦点.
- 尽管HbA1c升高 (>14%),但该患者的NKH没有满足HHS标准.
- 微妙的皮层下T2低压在MRI上在左尾极上被注意到.
- 症状在治疗一小时内迅速消失,在7个月的随访期间没有复发.
结论:
- 单独的非基性高血糖症可以导致尾叶发作.
- 在MRI上微妙的皮下T2低压可能是一个诊断指标.
- 快速识别和管理高血糖症对于糖尿病患者的控制至关重要.
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