Ryu Han Uk, Lee Seolwon, Shin Byoung-Soo, Kang Hyun Goo
Department of Neurology.
Department of Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, South Korea.
Medicine (Baltimore). 2019 Jul;98(29):e16483. doi: 10.1097/MD.0000000000016483.
Electroencephalographic (EEG) changes are frequently observed not only by epileptic seizures but also by metabolic encephalopathies. The EEG changes during hypoglycemia are known as mixed frequency theta to delta activity with higher amplitude than the initial background rhythm. Although there are many reports about hypoglycemia induced EEG changes, few studies of hypoglycemic EEG patterns have been evaluated between arousal and sleep stage.
A 45-year-old man who had been diagnosed as type 1 diabetes mellitus for 15 years admitted to the emergency room due to seizure attack. The EEG findings of the patient showed increased amplitude of theta slowing on both hemispheres. The abnormal EEG finding had recovered and the background frequency remarkably increased as the patient fell asleep, but reappeared when he woke up.
The patient was diagnosed as hypoglycemia with altered mentality.
Fifty percent dextrose fluid 50 mL was loaded and maintained with 10% dextrose water afterwards.
The patient improved after medical treatment.
The EEG presentation of hypoglycemia involves low frequency and increased amplitude of delta-theta activity. As the previous studies, we observed medium amplitude semi-rhythmic theta slowing EEG findings on both hemispheres during arousal, indicating hypoglycemia. However, it was stabilized during sleep as background frequency increased and medium amplitude of slowing disappeared. Although there are many reports about hypoglycemia induced EEG changes, few studies of hypoglycemic EEG patterns have been evaluated between arousal and sleep stage. We report a case of different EEG patterns between arousal and sleep stage during hypoglycemia.
脑电图（EEG）变化不仅常见于癫痫发作，也见于代谢性脑病。低血糖期间的脑电图变化表现为混合频率的θ波至δ波活动，其振幅高于初始背景节律。尽管有许多关于低血糖诱发脑电图变化的报道，但很少有研究评估觉醒期和睡眠期的低血糖脑电图模式。
一名45岁男性，15年前被诊断为1型糖尿病，因癫痫发作入住急诊室。患者的脑电图结果显示双侧半球θ波减慢的振幅增加。随着患者入睡，异常脑电图结果恢复，背景频率显著增加，但醒来时又再次出现。
患者被诊断为低血糖伴意识改变。
静脉推注50%葡萄糖液50毫升，随后用10%葡萄糖水维持。
经治疗后患者病情好转。
低血糖的脑电图表现为δ波-θ波活动的低频和振幅增加。正如之前的研究一样，我们观察到在觉醒期间双侧半球出现中等振幅的半节律性θ波减慢脑电图结果，提示低血糖。然而，在睡眠期间随着背景频率增加且中等振幅的减慢消失，脑电图趋于稳定。尽管有许多关于低血糖诱发脑电图变化的报道，但很少有研究评估觉醒期和睡眠期的低血糖脑电图模式。我们报告了一例低血糖期间觉醒期和睡眠期脑电图模式不同的病例。
