Endocrinol Metab.  2012 Jun;27(2):155-158. 10.3803/EnM.2012.27.2.155.

Visual Seizure: A Reversible Complication of Non-Ketotic Hyperglycemia

• Kim NY
• Park MS

• KMID: 1497657
• DOI: http://doi.org/10.3803/EnM.2012.27.2.155

Abstract

A 65-year-old man with diabetes mellitus was presented with left visual aura, followed by a versive seizure, each lasting approximately 3 minutes. Neurological examination showed an intermittent left homonymous hemianopsia. Brain magnetic resonance imaging (MRI) showed right occipital lobe lesion, with cytotoxic edema. Blood glucose was 593 mg/dL and serum osmolarity was 309 mOsm/kg. The seizures were controlled by normalization of blood sugar and short-term anticonvulsant, and the lesions were resolved in a follow-up MRI. We report a case of visual seizures associated with non-ketotic hyperglycemia.

Keyword

Diabetes mellitus; Nonketotic hyperglycemia; Visual seizure

MeSH Terms

Aged
Blood Glucose
Brain
Diabetes Mellitus
Edema
Epilepsy
Epilepsy, Partial, Motor
Follow-Up Studies
Hemianopsia
Humans
Hyperglycemia
Magnetic Resonance Imaging
Neurologic Examination
Occipital Lobe
Osmolar Concentration
Seizures
Blood Glucose

Figure

• 

  Fig. 1 Brain magnetic resonance imaging obtained at the 7th day after the symptoms onset. T2-weighted (A) and fluid attenuated inversion recovery image (B) show right occipital cortical hyperintensities and subcortical hypointensities and diffusion-weighted image (C) and apparent diffusion coefficient (D) demonstrate restricted D diffusion.

• 

  Fig. 2 Follow-up brain magnetic resonance imaging obtained at the 39th day after the onset of symptoms. Fluid attenuated inversion recovery image (A), diffusion-weighted image (B) and apparent diffusion coefficient (C) show resolution of previous abnormal signal intensity lesion.

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