Focal epileptic seizure induced by transient hypoglycaemia in insulin-treated diabetes
Tóm tắt
Hypoglycaemia, common in diabetic patients treated with insulin, can induce various neurological disturbances. Of these, seizures are the most common acute symptom, mainly of the generalised tonic-clonic type, with focal events only exceptionally being reported and documented. Hypoglycaemia can modify cortical excitability by determining an imbalance between excitation and inhibition; some brain structures, such as the temporal lobe and hippocampus, appear to be particularly susceptible to this insult. We describe a case of a 61-year-old diabetic patient in whom insulin-induced transient hypoglycaemia triggered a focal seizure of temporal origin that was well documented by EEG during 24-hour ambulatory monitoring. This is, to our knowledge, one of the few, well-documented cases of this type of seizure.
Tài liệu tham khảo
Auer RN. Hypoglycemic brain damage. Metabolic Brain Disease 2004; 19: 169–175.
Buckley RE. Vertiginous temporal lobe seizures by functional hyperinsulinism. JAMA 1963; 186: 726–727.
Caraballo RH, Sakr D, Mozzi M, et al. Symptomatic occipital lobe epilepsy following neonatal hypoglycaemia. Pediatr Neurol 2004; 31: 24–29.
Eeg-Olofsson O. Hypoglycaemia and neurological disturbance in children with diabetes mellitus. Acta Pediatr Scand 1977; 270: 91–96.
Kaplan PW. The EEG in metabolic encephalopathy and coma. J Clin Neurophysiol 2004; 21: 307–318.
Lahat E, Barr J, Bistritzer T. Focal epileptic episodes associated with hypoglycemia in children with diabetes. Clinical Neurology and Neurosurgery 1995; 97: 314–316.
McCall AL. Cerebral glucose metabolism in diabetes mellitus. European Journal of Pharmacology 2004; 490: 147–158.
Penfield W, Kristiansen H. Epileptic seizure patterns study of localizing phenomena in focal cortical seizures. C.C. Thomas. Springfield, III., 1951.
Varghese P, Gleason V, Sorokin R, et al. Hypoglycemia in hospitalized patients treated with antihyperglycemic agents. Journal of Hospital Medicine 2007; 4: 234–240.