J Korean Epilepsy Soc.  2009 Dec;13(2):71-74.

Occipital Lobe Simple Partial Epilepsy Presenting as Visual Episodes Associated with Non-Ketotic Hyperglycemia

• Roh H
• Lee KB
• Ahn MY

Abstract

Non-ketotic hyperglycemia (NKH) is recognized both as a direct cause of a precipitating factor of many types of epileptic seizure, including simple partial motor, complex partial as well as reflex motor seizure, choreoathetosis and ballismus. Its association with isolated visual alteration is less known. A 74-year-old diabetic woman with visual complaints manifested as flashing colorful lights (red, yellow and blue) in both visual field with progressive increase in frequency. Among the laboratory tests, NKH of 508mg/dL stood out. Slow waves from the right occipital region maximum at O2 associated with visual symptom were recorded in EEG. Brain MRI showed subcortical T2WI and FLAIR hypointensities in the right occipital lobe with scanty enhancement. Patient was treated with hydration and insulin and her symptoms disappeared after hyperglycemia was corrected. We stress that isolated visual episodes may be initial manifestation of occipital lobe simple partial seizure associated with NKH.

Keyword

Occipital lobe epilepsy; Non-ketotic hyperglycemia; Brain MRI

MeSH Terms

Aged
Brain
Dyskinesias
Electroencephalography
Epilepsies, Partial
Epilepsy
Female
Humans
Hyperglycemia
Insulin
Light
Occipital Lobe
Precipitating Factors
Reflex
Seizures
Visual Fields
Insulin