Whiting S, Camfield P, Arab D, Salisbury S
Department of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, Canada.
J Child Neurol. 1997 Apr;12(3):178-80. doi: 10.1177/088307389701200305.
Severe partial seizures may be the presenting feature of nonketotic hyperglycemia in older adults, but cases in children are rare. We report three teenagers with well-controlled epilepsy who suddenly developed intractable partial seizures poorly responsive to anticonvulsants. Blood glucose levels were measured only after several days of hospitalization for frequent seizures when mild polyuria and polydipsia were first noted. Glucose levels were high with mild ketosis and acidosis in one patient and no ketosis in two. With institution of insulin, there was prompt cessation of seizures. The patients were diagnosed as having type I insulin-dependent diabetes mellitus and require ongoing insulin treatment. Hyperglycemia should be considered in children with epilepsy who develop intractable seizures.
严重部分性癫痫发作可能是老年人非酮症高血糖的首发症状，但儿童病例罕见。我们报告了三名癫痫控制良好的青少年，他们突然出现难以控制的部分性癫痫发作，对抗惊厥药物反应不佳。在因频繁癫痫发作住院几天后，当首次发现轻度多尿和多饮时才测量血糖水平。一名患者血糖水平高，伴有轻度酮症和酸中毒，两名患者无酮症。使用胰岛素后，癫痫发作迅速停止。这些患者被诊断为Ⅰ型胰岛素依赖型糖尿病，需要持续胰岛素治疗。对于出现难治性癫痫发作的癫痫患儿，应考虑高血糖症。
