This epileptic convulsion is often first diagnosed in the neurology department, and misdiagnosis can have fatal consequences

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The patient, a 82-year-old woman, was admitted to the hospital

Clinically, patients with diabetic epilepsy are often first diagnosed in the emergency department and neurology department, and the emergency department and neurologist are not fully aware of the disease, and are given conventional sedative and anti-epileptic drug treatment, which is insensitive to the above treatment, which may aggravate the condition and even bring fatal consequences

Patients with non-ketotic hyperglycemia have a 19% to 25% chance of seizures, which are more common in patients over 50 years of age, and there is no difference

The mechanism of hyperglycemia causing seizures is still controversial, and the possible mechanisms are:

(1) Elderly people are more common, there is no previous history of epilepsy or diabetes, and only some patients have typical "three more and one less" symptoms

Considering that some anti-epileptic drugs may increase blood glucose and aggravate the condition, combined with the actual condition and willingness of patients, the plan is as follows: small doses of insulin control blood glucose, rehydration, improvement of microcirculation, after the above treatment, if there are still convulsive seizures, then give antiepileptic drugs with little impact on blood glucose such as carbamazepine, clonadipam and the like

[1] Lammouchi T，Zoghlami F，Ben Slamia L，et al． Epileptic seizures in non-ketotic hyperglycemia［J］．Neurophysiol Clin，2004，34(3-4):183-187．

[2] Scherer C．Seizures and non-ketotic hyperglycemia［J］．Presse Med，2005，34(15):1084-1086．

[3］Huang CW，Tsai JJ，Ou HY，et al． Diabetic hyperglycemia is associated with the severity of epileptic seizures in adults［J］．Epilepsy Res，2008，79(1):71-77．

Xie Xue Li.

[5] Cochin JP，Hannequin D，Delangre T，et al． Continuous partial epilepsy disclosing diabetes mellitus［J］．Rev Neurol，1994，150：239－241．

[6] John F． Reflex epilepsy and nonketotic hyperglycemia in the elderly：a specific neuroendocrine syndrome［J］．Neurology，1989，39：394．

[7] Singh BM，Gupta DR，Strobos RJ． Nonketotic hyperglycemia and epilepsia partialis continua［J］．Arch Neurol，1973，29（3）：187－190.

[8] Lammouchi T，Zoghlami F，Ben Slamia L，et al． Epileptic seizures in nonketotic hyperglycemia［J］．Neurophysiol Clin，2004，34（3－4）：183－187．

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