Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 5302

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

NEUROIMAGING Table of Contents   
Year : 2019  |  Volume : 29  |  Issue : 4  |  Page : 343-349
Hyperglycemia-induced seizures - Understanding the clinico- radiological association


1 Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Radiodiagnosis, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India
2 Department of Radiodiagnosis, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala; Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Karad, Maharastra, India
3 Department of Radiodiagnosis, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India
4 Department of Neurology, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India

Correspondence Address:
Dr. Amol A Gautam
Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Karad, Maharastra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijri.IJRI_344_19

Rights and Permissions

Objectives: To highlight the typical magnetic resonance imaging (MRI) findings in hyperglycemia-induced seizures and compare the results with similar previous studies with a brief mention of pathophysiological mechanisms. Materials and Methods: This retrospective study included medical and imaging records of six consecutive patients with hyperglycemia-induced seizures. The data analysis included a clinical presentation and biochemical parameters at admission. The MRI sequences were evaluated for region involved, presence of subcortical T2 hypo-intensity, cortical hyper-intensity, and restricted diffusion. Similar previous studies from the National Library of Medicine (NLM) were analyzed and compared with our study. Results: Twenty-four patients were included from four studies in previous literature for comparison. In our study, on imaging, posterior cerebral region was predominantly involved, with parietal involvement in 83.3%, followed by occipital, frontal, and temporal involvement in 33.3% patients compared with occipital in 58.3%, parietal in 45.8%, and frontal and temporal in 16.6% of patients in previous literature. The subcortical T2 hypo-intensity was present in 83.3% of the patients, cortical hyper-intensity in all patients, and restricted diffusion in 66.6% of the patients in our study compared with subcortical T2 hypo-intensity in 95.8% of the patients, cortical hyper-intensity in 62.5%, and restricted diffusion in 58.3% of the patients in previous literature. Conclusion: Although many etiologies present with subcortical T2 hypointensity, cortical hyperintensity, restricted diffusion, and postcontrast enhancement on MRI, the clinical setting of seizures in a patient with uncontrolled hyperglycemia, hyperosmolar state, and absence of ketones should suggest hyperglycemia-induced seizures to avoid misdiagnosis, unnecessary invasive investigations, and initiate timely management. Advances in Knowledge: Our study highlights the presence of posterior predominant subcortical T2, fluid-attenuated inversion recovery (FLAIR), and susceptibility-weighted angiography (SWAN) hypointensity; cortical hyperintensity; and restricted diffusion in hyperglycemia-induced seizures. The presence of T2 and SWAN hypointensity could support the hypothesis of possible deposition of free radicals and iron in the subcortical white matter.


[FULL TEXT] [PDF]*
Print this article     Email this article

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
  Citation Manager
 Access Statistics
  Reader Comments
  Email Alert *
  Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed432    
    Printed11    
    Emailed0    
    PDF Downloaded105    
    Comments [Add]    

Recommend this journal