Objective To investigate the clinical symptom and risk factors of diabetic seizures.
Methods The clinical data of 44 patients with diabetes related seizures were analyzed with the clinical classification, blood glucose, Na+, Plasma Osmotic Pressure, HbA1c, EEG, brain MR, and the antiepileptic drugs.
Results ① Diabetic hyperglycemia (DH) related seizures: among the 28 patients, 17 cases were male patients, 11 cases were female patients. The mean age was 51.3 years old. Simple partial seizure without secondary generalized seizures (12/28, 42.8%) was the most common, 8 patients (8/28, 28.6%) showed complex partial seizure, 8 patients (8/28, 28.6%) showed no obvious focal origin generalized tonic-closure seizures. Patients with poor glycemic control (HbA1c > 9%) had significantly higher risk of generalized seizures (46.7% vs. 7.7 %, P < 0.05) (P < 0.05). ② Diabetic ketoa-cidosis or hypertonic state associated seizures: among the 7 patients, 6 cases were male patients, 1case was female patients. The mean age was 45.7 years old, 2 patients (2/7, 28.6%) had generalized tonic-clonic seizure, 2 patients (2/7, 28.6%) showed status epilepticus, 2 patients (2/7, 28.6%) showed local motor seizure, 1 patient (1/7, 14.2%) showed Jackson seizure. ③ Diabetic hypoglycemia related seizures: among the 9 patients, 7 cases were male patients, 2 cases were female patients. The mean age was 45.3 years old.5 patients showed generalized tonic-clonic seizure (5/9, 55.6%), 3 patients had complex partial seizure (3/9, 33.3%), 1 patients had generalized tonic-closure seizures (1/9, 11.1%).
Conclusion Simple partial seizure is the most common in patients with diabetic hyperglycemia related seizures; so as to diabetic hypoglycemia and keto-acidosis, generalized seizures are relatively common. HbA1c can be an important risk factor of seizures for patients with hyperglycemia.
Citation：
WEI Chao, CHEN Yangmei. Clinical analysis of diabetes related seizures. Journal of Epilepsy, 2017, 3(2): 115-120. doi: 10.7507/2096-0247.20170016
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Copyright © the editorial department of Journal of Epilepsy of West China Medical Publisher. All rights reserved
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Cokar O, Aydin B, Ozer F. Non-ketotic hyperglycaemia presenting as epilepsia partialis continua. Seizure, 2004, 13(4): 264-269.
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- 1. Tiamkao S, Pratipanawatr T, Tiamkao S, et al. Seizures in nonketotic hyperglycaemia. Seizure, 2003, 12(6): 409-410.
- 2. Cochin JP, Hannequin D, Delangre T, et al. Continuous partial epilepsy disclosing diabetes mellitus. Rev Neurol (Paris), 1994, 150(3): 239-241.
- 3. Harden CL, Engelgau mm, Vinicor F, et al. Hyperglycemia presenting with occipital seizures. Epilepsia, 1991, 32(2): 215-220.
- 4. Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia, 2001, 42(6): 796-803.
- 5. Commission on the Classification and Terminology of the International League Against Epilepsy. Proposal for Revised Clinical and Electroencephalographic Classification of Epileptic Seizures. Epilepsia, 1981, 22(4): 489-501.
- 6. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care, 2006, 29(1): S43-48.
- 7. Saaddine JB, Cadwell B, Gregg EW, et al. Improvements in diabetes processes of care and intermediate outcomes: United States, 1988-2002. Ann Intern Med, 2006, 144(7): 465-474.
- 8. 孔静波, 潘守政.低血糖致痫性发作38例临床分析.临床内科杂志, 2003, 20(12): 657-658.
- 9. Marcovecchio ML, Petrosino MI, Chiarelli F. Diabetes and epilepsy in children and adolescents. Curr Diab Rep, 2015, 15(4): 21.
- 10. Kim DW, Moon Y, Gee Noh H, et al. Blood-brain barrier disruption is involved in seizure and hemianopsia in nonketotic hyperglycemia. Neurologist, 2011, 17(3): 164-166.
- 11. Mc Call AL. Cerebral glucose metabolism in diabetes mellitus. Eur J Pharmacol, 2004, 490(1-3): 147-158.
- 12. Cokar O, Aydin B, Ozer F. Non-ketotic hyperglycaemia presenting as epilepsia partialis continua. Seizure, 2004, 13(4): 264-269.
- 13. Baekkeskov S, Aanstoot HJ, Christgau S, et al. Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature, 1990, 347(6289): 151-156.
- 14. Verrotti A, Scaparrotta A, Olivieri C, et al. Seizures and type 1 diabetes mellitus: current state of knowledge. Eur J Endocrinol, 2012, 167(6): 749-758.
