Hyperglycemia with occipital seizures: Images and visual evoked potentials

被引:30
作者
Wang, CP
Hsieh, PF
Chen, CCC
Lin, WY
Hu, WH
Yang, DY
Chang, TH
机构
[1] Taichung Vet Gen Hosp, Dept Emergency Med, Taichung 407, Taiwan
[2] Taichung Vet Gen Hosp, Dept Neurol, Taichung 407, Taiwan
[3] Taichung Vet Gen Hosp, Dept Radiol, Taichung 407, Taiwan
[4] Taichung Vet Gen Hosp, Dept Nucl Med, Taichung 407, Taiwan
[5] Natl Yang Ming Univ, Dept Internal Med, Taipei 112, Taiwan
[6] Natl Chi Nan Univ, Grad Inst Biomed & Biomed Technol, Nantou Hsien, Taiwan
关键词
nonketotic hyperglycemia; hemianopsia; visual evoked potentials; magnetic resonance imaging;
D O I
10.1111/j.1528-1167.2005.56404.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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. Follow-up 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.
引用
收藏
页码:1140 / 1144
页数:5
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