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

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.