Homonymous hemianopia in nonketotic hyperglycemia is an ictal phenomenon

Neurology. Clinical Practice
Aaron StaymanNabil J Azar

Abstract

Extended video-EEG or18F-fluorodeoxyglucose PET (FDG-PET) was obtained in 3 adult patients with hemianopia secondary to nonketotic hyperglycemia. Two male patients presented with left hemianopia and episodic left gaze deviation and one male patient presented with right hemianopia and visual hallucinations. None of the 3 patients had a history of seizures or known epilepsy risk factors. All 3 patients were found to have elevated serum glucose (267 mg/dL, 320 mg/dL, and 487 mg/dL) without acidosis or urine ketones. In all 3 patients, video-EEG recorded recurrent ictal discharges originating from the posterior quadrant contralateral to their hemianopia. In 2 patients, FDG-PET demonstrated corresponding focal areas of hypermetabolism. Resolution of visual symptoms was achieved with antiepileptic drugs, hydration, and tight glycemic control.

Citations

Mar 28, 2020·Journal of Diabetes Investigation·Chika MizuguchiToru Aizawa
Mar 18, 2021·World Journal of Clinical Cases·Xiao-Hui XiangGuo-Hua Zhao
Nov 5, 2021·JAMA Ophthalmology·Jingyi MaJonathan A Micieli

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