Stayman Aaron, Abou-Khalil Bassel W, Lavin Patrick, Azar Nabil J
Veteran's Administration Medical Center (AS, NJA) and Vanderbilt University Medical Center (AS, BWA-K, PL, NJA), Nashville, TN.
Neurol Clin Pract. 2013 Oct;3(5):392-397. doi: 10.1212/CPJ.0b013e3182a7bb76.
Extended video-EEG or F-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.
对3例继发于非酮症高血糖的偏盲成年患者进行了延长视频脑电图或氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）检查。2例男性患者表现为左侧偏盲和发作性左侧凝视偏斜，1例男性患者表现为右侧偏盲和视幻觉。这3例患者均无癫痫发作史或已知的癫痫危险因素。所有3例患者的血糖均升高（分别为267 mg/dL、320 mg/dL和487 mg/dL），无酸中毒或尿酮体。在所有3例患者中，视频脑电图记录到起源于与偏盲对侧后象限的反复发作期放电。2例患者的FDG-PET显示相应的局灶性高代谢区域。通过抗癫痫药物、补液和严格的血糖控制，视觉症状得到缓解。
