J Korean Neurol Assoc.  2018 Aug;36(3):178-184. 10.17340/jkna.2018.3.7.

The Clinical Presentations and Prognosis of Non-Ketotic Hyperglycemia Induced Seizure

Affiliations
  • 1Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medical, Gangneung, Korea.
  • 2Division of Endocrinology, Gangneung Asan Hospital, University of Ulsan College of Medical, Gangneung, Korea.
  • 3Department of Preventive Medicine, College of Medicine, Catholic Kwandong University, Gangneung, Korea. songjs@cku.ac.kr

Abstract

BACKGROUND
Seizure can be triggered by the non-ketotic hyperglycemia (NKH). Recently we analysed 18 cases of NKH induced seizure to identify the causes for NKH, seizure types, prognosis, and the differences of clinical presentation between the patient with chronic brain structural lesion (CBSL) and the patient without.
METHODS
Eighteen patients with NKH induced seizure were selected from the database. Data regarding brain images, clinical symptoms, co-morbid illnesses, blood laboratories, and prognosis were collected. Patients were divided into two groups according to the presence of CBSL.
RESULTS
The patients with CBSL showed more generalized tonic-clonic seizure (GTCS) than without. Focal seizures in this group appeared to be originated from the pre-existing lesion in many situations. The poor compliance to anti-diabetic treatment and physical stresses were most common causes for NKH. One year seizure remission without anti-epileptic drug treatment was achieved in 17 of 18 patients.
CONCLUSIONS
The patients with CBSL might have more GTCS than without. The impairment of inhibitory mechanism surrounding the focal irritative zone might be one of plausible explanation for this phenomenon. The prognosis was favorable. Further large studies are required.

Keyword

Non-ketotic hyperglycemia; Seizure; Brain lesion; Generalized tonic-clonic seizure; Prognosis
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