Subject(s)
Liver Diseases/complications , Paraparesis, Spastic/etiology , Spinal Cord Diseases/etiology , Female , Humans , MaleABSTRACT
Seizures are common in hyperglycemia and are often the first manifestation particularly in non-ketotic hyperglycemia (NKH). Published reports emphasize partial motor seizures almost exclusively. Here we present the clinical, biological and electrophysiological features of 22 consecutive patients with NKH who developed focal seizures and were treated in our department. Neurological exam was normal in 15 cases. When abnormal, it showed postictal obnubilation or diabetic polyneuropathy. Interictal EEG (obtained in 17 patients) showed focal or generalised slowing in 65% of cases, and ictal EEG (six patients) showed rapid spikes most often unilateral. CTs were normal in 77% of cases, and showed age-compatible cortico-subcortical atrophy in the others. All patients were alert, with glucose values between 13.6 and 55 mmoles/l and osmolarity values increased in all cases to a mild or moderate extent (266-309.20 mosm/l). Three out of 22 patients (14%) presented with motor epilepsy partialis continua. In 11/22 cases (50%), diabetes mellitus had not been diagnosed previously. Seizures associated with NKH were resistant to anticonvulsant treatment but responded well to insulin therapy and rehydration. They subsided completely in an average of 4 days, and only one patient had to be transiently transferred to ICU. We conclude on the importance of an early diagnosis of this condition to prevent malignant evolution of the epileptic syndrome into a state of hyperosmolarity and coma associated with a much higher mortality.
Subject(s)
Epilepsy/etiology , Hyperglycemia/complications , Aged , Atrophy , Blood Glucose/metabolism , Disease Progression , Electroencephalography , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neurologic Examination , Seizures/etiology , Tomography, X-Ray ComputedABSTRACT
Epilepsy is 5 to 7 times more frequent among patients with myasthenia than in the general population. Myasthenia gravis is often associated with other affectsion, most of immunological origin. However, hypotheses explaining the association are still uncertain. We report a case of association in a woman who had epilepsy since the age of 9 years and developed myasthenia at the age of 23 years after having discontinued here anti-epileptic treatment for two years.
Subject(s)
Epilepsy/complications , Epilepsy/drug therapy , Neuromuscular Junction Diseases/complications , Adult , Anticonvulsants/therapeutic use , Electroencephalography , Epilepsy/diagnosis , Female , Humans , Neuromuscular Junction Diseases/diagnosis , Thymus Gland/pathologyABSTRACT
This 71 years old women without any history of epilepsy had diabetes mellitus. She was admitted for repetitive giratory seizures in relation with non-ketotic hyperglycaemia. The EEG showed right centro-parietal paroxysmal slow activity. Symptomatology disappeared within 48 hours after insulin therapy. One month later, she presented with a left hemiplegia in relation with a right sylvian infraction. The role of focal transitory ischaemia in connection with hyperglycaemia is discussed.
