Seizure as the first presentation of diabetes mellitus

Omar, Hesham R.; El-Khabiry, Ehab; Vaughan, Susan C.

doi:10.1177/2042018812459879

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…In some cases, partial seizures are the presenting feature of undiagnosed diabetes mellitus. This was initially described by Maccario and colleagues in 1965 [2] and later by others [3] , [4] , [5] . The most commonly encountered seizure types in NKH are focal motor seizures and epilepsia partialis continua [6] .…”

Section: Discussionmentioning

confidence: 82%

Occipital seizures and subcortical T2 hypointensity in the setting of hyperglycemia

Putta

Weisholtz

Milligan

2014

Epilepsy & Behavior Case Reports

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IntroductionOccipital lobe seizures are a recognized manifestation of diabetic nonketotic hyperglycemia, though not as common as focal motor seizures. Occipital lobe white matter T2 hypointensity may suggest this diagnosis.MethodsWe present a case of a 66-year-old man with hyperglycemia-related occipital lobe seizures who presented with confusion, intermittent visual hallucinations, and homonymous hemianopia.ResultsMagnetic resonance imaging showed subcortical T2 hypointensity within the left occipital lobe with adjacent leptomeningeal enhancement. These findings were transient with disappearance in a follow-up MRI. The EEG captured frequent seizures originating in the left occipital region. HbA1c level was 13.4% on presentation, and finger stick blood glucose level was 400 mg/dl.ConclusionHyperglycemia should be considered in the etiology of differential diagnosis of patients with visual abnormalities suspicious for seizures, especially when the MRI shows focal subcortical T2 hypointensity with or without leptomeningeal enhancement.

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Section: Discussionmentioning

confidence: 82%

Occipital seizures and subcortical T2 hypointensity in the setting of hyperglycemia

Putta

Weisholtz

Milligan

2014

Epilepsy & Behavior Case Reports

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“…Secondly,thepossibilityofareversecausalitycannotberuledout.Inotherwords,apatient withcovertdiabetesmaydevelopanepilepticseizureasthefirstmanifestationofdiabetes (Omar, El-Khabiry, & Vaughan, 2012) and may thus be prescribed AEDs. A presumption of a causal associationisthattheexposuretotheriskfactor(medicationuse)occursfirstandislaterfollowed bytheoccurrenceofthedisease(diabetes).Hence,theuseofathree-monthlagtimeperiodbetween medicationuseandnewlydiagnoseddiabetesinthestudydesignmayhelpamelioratetheriskof reversecausation (Pottegårdetal.,2018).…”

Section: Limitationsmentioning

confidence: 99%

Medication Use and the Risk of Newly Diagnosed Diabetes in Patients with Epilepsy

Sung

Lee

Hsieh

et al. 2020

Journal of Organizational and End User Computing

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Epilepsy is a common neurological disorder that affects millions of people worldwide. Patients with epilepsy generally require long-term antiepileptic therapy and many of them receive polypharmacy. Certain medications, including older-generation antiepileptic drugs, have been known to predispose patients to developing diabetes. Although data mining techniques have become widely used in healthcare, they have seldom been applied in this clinical problem. Here, the authors used association rule mining to discover drugs or drug combinations that may be associated with newly diagnosed diabetes. Their findings indicate in addition to the most common culprits such as phenytoin and valproic acid, prescriptions containing carbamazepine, oxcarbazepine, or lamotrigine may be related to the development of newly diagnosed diabetes. These mined rules are useful as guidance to both clinical practice and future research.

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“…Dengan demikian, iskemia fokal yang telah terbentuk sebelumnya menjadi bersifat ireversibel dikarenakan penurunan aliran darah ke area serebral. 9,12 Pasien diabetes usia tua yang mengalami hiperglikemia non-ketosis dengan gambaran klinis hemichorea-hemiballismus memiliki gambaran radiologis CT scan berupa hiperdensitas ganglia basalis kontralateral. Namun demikian, masih banyak perdebatan mengenai mekanisme terjadinya perubahan gambaran radiologis pada CT scan tersebut.…”

Section: Diskusiunclassified

Kasus Serial Sindrom Hemichorea-Hemiballismus terkait Non-Ketotik : Tantangan dalam Proses Diagnosis

Sasiarini¹,

Budianto²,

Tarigan³

2019

JPDI

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Diabetes melitus merupakan penyakit yang banyak ditemui sehari-hari, akan tetapi memiliki manifestasi klinis yang tidak lazim. Salah satu manifestasinya adalah sindroma hemichorea-hemiballismus, spektrum gerakan involunter yang berlangsung terus-menerus tanpa pola dan melibatkan satu sisi tubuh akibat hiperglikemia non-ketotik pada diabetes yang tidak terkontrol. Dilaporkan dua kasus pasien diabetes dengan hiperglikemia non-ketotik yang mengalami sindrom hemichorea-hemiballismus. Kasus pertama-wanita 57 tahun mengalami gerakan involunter, repetitif, dan tidak berirama di lengan dan tungkai kanan, disertai kedutan di wajah kanan selama dua minggu. Pasien tersebut memiliki riwayat diabetes melitus tidak terkontrol. Kasus kedua-laki-laki 60 tahun dengan kejang umum tonik-klonik. Pasien mengalami gerakan involunter pada lengan kanan selama empat hari dan riwayat diabetes sebelumnya tidak diketahui. Terapi diazepam intravena tidak memberikan respons terhadap kejang. Gambaran CT scan kepala pada kedua pasien menunjukkan lesi hiperdens pada ganglia basalis yang diduga disebabkan oleh hiperglikemia non-ketotik, akan tetapi lesi hiperdens pada pasien kedua tampak lebih luas. Gerakan involunter membaik setelah target glukosa darah tercapai dengan rehidrasi dan insulin intravena kontinyu. Respons klinis pada kasus hemichorea-hemiballismus di atas bersifat reversibel meskipun gambaran lesi hiperdens dapat bertahan selama berbulan-bulan.

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Seizure as the first presentation of diabetes mellitus

Cited by 5 publications

References 9 publications

Occipital seizures and subcortical T2 hypointensity in the setting of hyperglycemia

Occipital seizures and subcortical T2 hypointensity in the setting of hyperglycemia

Medication Use and the Risk of Newly Diagnosed Diabetes in Patients with Epilepsy

Kasus Serial Sindrom Hemichorea-Hemiballismus terkait Non-Ketotik : Tantangan dalam Proses Diagnosis

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