Nonketotic hyperglycemia-related epileptic seizures

Abstract 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