Summary:Purpose: Hyperglycemia may rarely be seen with visual seizures. Observation of both visual evoked potentials (VEPs) and magnetic resonance imaging (MRI) in visual status epilepticus (SE) has not been reported. We describe acute and follow-up VEP and MRI findings of a patient with hyperglycemia-related visual SE of occipital origin.Methods: In a 59-year-old diabetic woman, complex visual hallucinations and illusions developed with ≤10 seizures per hour as an initial manifestation of nonketotic hyperglycemia.Results: Neurologic examination revealed ictal nystagmus to the right and continuous right hemianopsia. Ictal electroencephalography (EEG) and Tc-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission computed tomography (SPECT) revealed an epileptogenic focus in the left occipital lobe. MRI with fluid-attenuated inversion recovery showed focal subcortical hypointensity and gyral hyperintensity. Followup MRI showed only minimal gyral hyperintensity at 6 months. The P100 amplitude of VEP was significantly higher at the right occipital area during SE, but slightly higher on the left after the patient had been seizure free for 6 months.Conclusions: Occipital seizures and hemianopsia can be caused by hyperglycemia and may be accompanied by special MRI and VEP findings. Key Words: Nonketotic hyperglycemia-Hemianopsia-Visual evoked potentialsMagnetic resonance imaging.Nonketotic hyperglycemia (NKH) is a clinical syndrome consisting of severe hyperglycemia, hyperosmolality, and intracellular dehydration without ketoacidosis. Only a few cases of NKH-related occipital visual seizures have been reported (1-4).Partial status epilepticus (SE) can be defined as (a) >30 min of abnormal neurologic function at the time of EEG, and (b) at least two discrete EEG seizures or continuous rapid (≥1.5 Hz) epileptiform discharges (5).Observation of both visual evoked potential (VEP) and magnetic resonance imaging (MRI) abnormalities in hyperglycemia-related visual SE has never been reported. We describe immediate and follow-up VEP and MRI findings of a patient with visual SE due to NKH.

No abstract

No abstract

No abstract