Focal seizures related to non-ketonic hyperglycemia - abstract

ABSTRACT

The aim of this paper is to highlight the association of non-ketonic hyperglycemia and focal seizures. Six patients, including 3 previously undiagnosed diabetics, were seen at the Queen Elizabeth Hospital, Barbados. All patients (except Case 5) were seen by at least one of the authors, while Case 4 was an outpatient whose case notes were reviewed. Three patients showed movement-induced or kinesignetic seizures, 2 had significant post-ictal weakness of the involved limb which was the arm in 5 patients and both limbs in 3. The face was involved either alone (1 patient) or with the arm (2 patients). There was one example of Epilepsia partialis Continua and 3 patients had recurrent episodes of focal seizures when glucose control was lost. Glucose values varied from 17.8 to 55.1 mmol/l, while calculated osmolarity values were elevated in all cases to a mild or moderate extent (299.1 to 346.5 mosmoles/l). The occurrence of focal seizures in the middle-aged or elderly patient should signal the possibility of diabetes mellitus. These seizures are refractory to anticonvulsant therapy and respond best to insulin and rehydration(AU)