Objective:To investigate nonketotic hyperglycemia (NKH)-related epileptic clinical features and pathogenesis,and improve the diagnosis and treatment.Methods:Clinical data,including the clinical manifestations,laborato...Objective:To investigate nonketotic hyperglycemia (NKH)-related epileptic clinical features and pathogenesis,and improve the diagnosis and treatment.Methods:Clinical data,including the clinical manifestations,laboratory tests,imaging studies and other information,of 13 patients with hyperglycemia-related epilepsy in our department were retrospectively analyzed.Results:Blood glucose levels of the 13 patients when admitted to the hospital ranged between 24.7-34.6 mmol/L (average 28.3 mmol/L),their plasma osmolality ranged between 290-332 mOsm/L (average 308 mOsm/L),and their ketone results were negative.Among them,seven had convulsions,4 had upper limbs and facial twitching,and 2 had bust twitch.Imaging findings could not detect accountable lesions related to seizures.EEG mainly showed spikes,slow waves,and scattered sharp slow waves.Insulin combined short-term antiepileptic drugs,allowed the epilepsy to be effectively controlled without recurrence.Interpretation:Patients with episodes of NKH epilepsy increased significantly with hyperglycemia.Raising awareness of the disease,early diagnosis,and very early lowering the hyperglycemia levels,can effectively control the seizures.Lowering blood glucose is an effective way to control blood glucose levels.展开更多
BACKGROUND Nonketotic hyperglycemia(NKH)is characterized by hyperglycemia with little or no ketoacidosis.Diverse neurological symptoms have been described in NKH patients,including choreoathetosis,hemiballismus,seizur...BACKGROUND Nonketotic hyperglycemia(NKH)is characterized by hyperglycemia with little or no ketoacidosis.Diverse neurological symptoms have been described in NKH patients,including choreoathetosis,hemiballismus,seizures,and coma in severe cases.Homonymous hemianopia,with or without occipital seizures,caused by hyperglycemia is less readily recognized.CASE SUMMARY We describe a 54-year-old man with NKH,who reported seeing round,colored flickering lights with right homonymous hemianopia.Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe,with decreased T2 signal of the white matter,restricted diffusion,and corresponding low signal intensity in the apparent diffusion coefficient map.He responded to rehydration and a low-dose insulin regimen,with improvements of his visual field defect.CONCLUSION Patients with NKH may present focal neurologic signs.Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.展开更多
文摘Objective:To investigate nonketotic hyperglycemia (NKH)-related epileptic clinical features and pathogenesis,and improve the diagnosis and treatment.Methods:Clinical data,including the clinical manifestations,laboratory tests,imaging studies and other information,of 13 patients with hyperglycemia-related epilepsy in our department were retrospectively analyzed.Results:Blood glucose levels of the 13 patients when admitted to the hospital ranged between 24.7-34.6 mmol/L (average 28.3 mmol/L),their plasma osmolality ranged between 290-332 mOsm/L (average 308 mOsm/L),and their ketone results were negative.Among them,seven had convulsions,4 had upper limbs and facial twitching,and 2 had bust twitch.Imaging findings could not detect accountable lesions related to seizures.EEG mainly showed spikes,slow waves,and scattered sharp slow waves.Insulin combined short-term antiepileptic drugs,allowed the epilepsy to be effectively controlled without recurrence.Interpretation:Patients with episodes of NKH epilepsy increased significantly with hyperglycemia.Raising awareness of the disease,early diagnosis,and very early lowering the hyperglycemia levels,can effectively control the seizures.Lowering blood glucose is an effective way to control blood glucose levels.
基金The fund of Department of Education Zhejiang Province Scientific Research Project,No.Y201839721Zhejiang Province Medical Science and Technology Project,No.2017174708,No.2020RC061,and No.2018273034+2 种基金the Zhejiang Provincial Natural Scientific Foundation of China,No.LGF20H090011 and No.LY18H090002Zhejiang public welfare Technology Application Research Project,No.LGF20H090011the Medical and Health Science and Technology Program of Zhejiang Province,No.2018273034.
文摘BACKGROUND Nonketotic hyperglycemia(NKH)is characterized by hyperglycemia with little or no ketoacidosis.Diverse neurological symptoms have been described in NKH patients,including choreoathetosis,hemiballismus,seizures,and coma in severe cases.Homonymous hemianopia,with or without occipital seizures,caused by hyperglycemia is less readily recognized.CASE SUMMARY We describe a 54-year-old man with NKH,who reported seeing round,colored flickering lights with right homonymous hemianopia.Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe,with decreased T2 signal of the white matter,restricted diffusion,and corresponding low signal intensity in the apparent diffusion coefficient map.He responded to rehydration and a low-dose insulin regimen,with improvements of his visual field defect.CONCLUSION Patients with NKH may present focal neurologic signs.Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.
