Occipital Seizures and Persistent Homonymous Hemianopia (HH) With MRI Subcortical T2 Hypointensity in a Newly Diagnosed Diabetic Patient

Abstract

Non-ketotic hyperglycemia (NKH) can often cause seizures. Although these are usually in the form of focal seizures, occipital seizures have also been reported in case reports. Patients may present with complaints ranging from blurred vision and bright lights to homonymous hemianopia (HH) in occipital seizures due to hyperglycemia. Seizures can often be brought under control in a short time with good glycemic control. Seizures associated with NKH may cause subcortical T2 hypointensity on MRI in the occipital lobes and occipital epileptiform discharges on the electroencephalogram. In this case study, we aim to present a newly diagnosed diabetes mellitus patient who had homonymous hemianopsia in his neurological examination, had imaging and electrophysiological findings consistent with his examination and clinical findings, was admitted 15 days after his symptoms started, and whose seizures could not be controlled by glucose regulation. In this context, we evaluated the literature and compared our case to other patients who required anti-seizure drugs, with the goal of emphasizing the need of early treatment in seizures caused by NKH.