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Hyperglycemic Seizures

Focal Seizures And Hyperglycemia

Focal Seizures And Hyperglycemia

The case presented here illustrates the cerebral consequences of hyperosmotic nonketotic coma. A 49 year old Negro man had a blood sugar of 703 mg per 100 ml and a serum sodium of 151 mEq per liter, but negative serum and urine acetone. Death followed a six day course complicated by hemiparesis on the right side, right central facial weakness, and left-sided seizures. Continue reading >>

Children Experiencing First-time Or Prolonged Febrile Seizure Are Prone To Stress Hyperglycemia

Children Experiencing First-time Or Prolonged Febrile Seizure Are Prone To Stress Hyperglycemia

The risk factors and clinical implications of stress hyperglycemia in children with febrile seizure remain uncertain. Among 479 children with febrile seizure, the prevalence of the stress hyperglycemia (blood glucose concentration ≥ 150 mg/dL) was 10.0%. Stress hyperglycemia group included larger proportion of first-time febrile seizure, prolonged febrile seizure, and smaller proportion of short febrile seizure in comparison with the non–stress hyperglycemia group. Stress hyperglycemia group demonstrated a lower pH and higher lactate levels than the non–stress hyperglycemia group. Multivariate analysis revealed that first-time febrile seizure (aOR = 3.741, P = .004) and prolonged febrile seizure (aOR = 12.855, P < .001) were significant risk factors for stress hyperglycemia. The rate of early febrile seizure recurrence in the emergency department was not different between the groups. These findings suggest that children experiencing first-time or prolonged febrile seizure are prone to stress hyperglycemia, and this can be related to febrile seizure severity. However, stress hyperglycemia is not predictive of early febrile seizure recurrence in the emergency department. Continue reading >>

Seizures

Seizures

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian. A seizure is defined as a paroxysmal, transitory disturbance of brain function that has a sudden onset, ceases spontaneously, and has a tendency to recur. Generalized seizures affect the entire body. Most commonly, animals will fall to the side, make paddling movements with the limbs; they will often will urinate, salivate and defecate during the episodes. Generalized seizures usually last from several seconds to upwards of a couple minutes. Focal seizures remain localized to one body region and are usually shorter in duration, lasting a couple seconds. Seizures may start focal and then become generalized. After the veterinarian is convinced that a seizure disorder is present, the most important question to be answered is whether the seizure is the result of primary brain disease (intracranial disease), or the result of a disturbance outside the brain (extracranial disease), The most common intracranial causes of seizures include: structural disease including hydrocephalus, head trauma, inflammatory brain disease (encephalitis), strokes and neoplasia (brain cancer). The most common causes of extracranial diseases that cause secondary brain signs include: toxins and metabolic diseases. Metabolic diseases include: low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), liver disease, kidney disease, electrolyte disturbances, toxins (poisons), anemia. Idiopathic epilepsy Idiopathic epilepsy is another common cause of seizures in dogs and less commonly in cats. It is by definition, seizures of unknown cause. These episodes are thought to be due to "mal-wiring" within the brain. Idiopathic epilepsy is seen in dogs between the ages of 6 Continue reading >>

Non-ketotic Hyperglycaemic Seizures

Non-ketotic Hyperglycaemic Seizures

Non-ketotic hyperglycaemic seizures are one of the neurological complications of non-ketotic hyperglycaemia, along with non-ketotic hyperosmolar coma and non-ketotic hyperglycaemic hemichorea. Epidemiology Seizures in the context of non-ketotic hyperglycaemia are most frequently reported in middle-age to elderly patients with type 2 diabetes mellitus, with one relatively large study reporting an average age of 61 years without any significant gender predilection 1. It has been reported that up to 25% of patients with non-ketotic hyperglycaemia develop seizures 1. Interestingly, seizures are comparatively very rare in ketotic hyperglycaemia (or diabetic ketoacidosis) 1. Clinical presentation Seizures are seen in early stages of non-ketotic hyperglycaemia, usually days before coma manifests 1-5. Most commonly the seizures are focal motor seizures, with a temporal lobe focus, and are often recurrent (epilepsia partialis continua or partial status epilepticus), however focal seizures with an occipital lobe focus have also been reported 1-5. Symptoms usually resolve upon normalisation of glucose levels 1-5. Pathology The exact underlying pathophysiology of seizures in non-ketotic hyperglycaemia remains unclear 4. Although there are many hypotheses, it is likely that the pathogenesis is multi-factorial, considering 4: an acidic pH is required for gamma-aminobutyric acid (GABA) synthesis from glutamic acid, and because ketoacidosis does not occur in non-ketotic hyperglycaemia there theoretically could be a decrease in GABA 4 patients with type 2 diabetes mellitus, and thus at risk of developing non-ketotic hyperglycaemia, are more likely to have underlying structural and vascular anomalies which may contribute to a higher risk of seizures 4 patients are often hyponatraemic at Continue reading >>

Diabetic Hyperglycemia Aggravates Seizures And Status Epilepticus-induced Hippocampal Damage

Diabetic Hyperglycemia Aggravates Seizures And Status Epilepticus-induced Hippocampal Damage

Abstract Epileptic seizures in diabetic hyperglycemia (DH) are not uncommon. This study aimed to determine the acute behavioral, pathological, and electrophysiological effects of status epilepticus (SE) on diabetic animals. Adult male Sprague-Dawley rats were first divided into groups with and without streptozotocin (STZ)-induced diabetes, and then into treatment groups given a normal saline (NS) (STZ-only and NS-only) or a lithium-pilocarpine injection to induce status epilepticus (STZ + SE and NS + SE). Seizure susceptibility, severity, and mortality were evaluated. Serial Morris water maze test and hippocampal histopathology results were examined before and 24 h after SE. Tetanic stimulation-induced long-term potentiation (LTP) in a hippocampal slice was recorded in a multi-electrode dish system. We also used a simulation model to evaluate intracellular adenosine triphosphate (ATP) and neuroexcitability. The STZ + SE group had a significantly higher percentage of severe seizures and SE-related death and worse learning and memory performances than the other three groups 24 h after SE. The STZ + SE group, and then the NS + SE group, showed the most severe neuronal loss and mossy fiber sprouting in the hippocampal CA3 area. In addition, LTP was markedly attenuated in the STZ + SE group, and then the NS + SE group. In the simulation, increased intracellular ATP concentration promoted action potential firing. This finding that rats with DH had more brain damage after SE than rats without diabetes suggests the importance of intensively treating hyperglycemia and seizures in diabetic patients with epilepsy. Notes This work was partly supported by grants from the National Science Council (NSC-96-2314-B-006-059) and National Cheng Kung University Hospital (NCKUH-2007-023 and Continue reading >>

High Blood Sugar In Dogs

High Blood Sugar In Dogs

Hyperglycemia in Dogs A dog with abnormally high levels of glucose in the blood is said to have hyperglycemia. A simple carbohydrate sugar that circulates in the blood, glucose is a major source of energy for the body, of which normal levels range between 75-120mg. Insulin, a hormone that is produced and released by the pancreas into the bloodstream when glucose levels rise, plays a key role in maintaining normal sugar levels. Low levels or absolute deficiency of insulin results in abnormally high blood sugar levels. Some of the causes for hyperglycemia may be pancreatitis, and the resulting inability to produce insulin; normally occurring hormones, especially in female dogs; diet; and infections of the body (such as teeth, or urinary tract). Middle aged and older dogs are more at risk for developing hyperglycemia, and it is more common in female dogs than in males. Any breed can be affected, but some smaller breeds appear to be more disposed, including beagles, cairn terriers, dachshunds, miniature poodles and schnauzers. Symptoms and Types Clinical symptoms may vary depending on the underlying disease/condition. Your dog may not be showing any serious symptoms, especially those if the increased sugar is thought to be temporary, hormonal, or stress induced hyperglycemia. Some of the more common symptoms include: Depression Weight loss Excessive hunger Dehydration Bloodshot eyes (due to inflamed blood vessels) Liver enlargement Nerve damage in legs Severe depression (in cases of very high blood sugar levels) Non-healing wounds;infection is increased as the excess sugar feeds fungal and bacterial invaders Tissue damage (due to oxidizing [burning] effect of the excess sugar in the tissue) Causes Other than high stress situations, harmful drug interactions (such as with he Continue reading >>

Diabetic Seizures In Dogs

Diabetic Seizures In Dogs

Seeing your dog have a seizure can be pretty scary, especially the first time this happens. If the seizure is caused by diabetes complications, the good news is that future seizures can be prevented by controlling the dog's diabetes. Why Seizures Happen Any seizure—in a dog or a human—is caused by a kind of electrical storm in the brain. If a dog has diabetes, her body doesn't produce the right amount of insulin for control of blood sugar levels. Insulin is produced by the pancreas, and diabetes can be caused by too much or too little. Very low blood sugar levels can interrupt the normal functioning of the brain, leading to a diabetic seizure. Hypoglycemia and Hyperglycemia Problems relating to diabetes in dogs usually stem from a state of either hypoglycemia or hyperglycemia. A hypoglycemic dog has very low blood sugar and may experience a seizure as a result. In diabetic dogs, hypoglycemia commonly occurs when an insulin dose is given without sufficient food for the dog's body to utilize the insulin properly. The opposite diabetic state, hyperglycemia, occurs when the dog's blood sugar levels are extremely high. Although hyperglycemia does not typically cause seizures, this is a serious state in which the dog may become depressed, weak and anorexic. Hyperglycemia can cause a dog to become comatose. Seizure Prevention If your dog is diabetic, seizure prevention primarily involves preventing a state of hypoglycemia. Use insulin that is formulated specifically for dogs—Novolin, Vetsulin and Caninsulin are some of the most commonly used forms of canine insulin. Monitor your dog's blood glucose regularly to make sure the insulin dosage is correct and having the desired effect. Monitor your dog's feeding and exercise patterns, if possible with a regular daily schedule Continue reading >>

Nonketotic Hyperglycemia-related Epileptic Seizures

Nonketotic Hyperglycemia-related Epileptic Seizures

Abstract To investigate nonketotic hyperglycemia (NKH)-related epileptic clinical features and pathogenesis, and improve the diagnosis and treatment. Clinical data, including the clinical manifestations, laboratory tests, imaging studies and other information, of 13 patients with hyperglycemia-related epilepsy in our department were retrospectively analyzed. Blood glucose levels of the 13 patients when admitted to the hospital ranged between 24.7-34.6 mmol/L (average 28.3 mmol/L), their plasma osmolality ranged between 290–332 mOsm/L (average 308 mOsm/L), and their ketone results were negative. Among them, seven had convulsions, 4 had upper limbs and facial twitching, and 2 had bust twitch. Imaging findings could not detect accountable lesions related to seizures. EEG mainly showed spikes, slow waves, and scattered sharp slow waves. Insulin combined short-term antiepileptic drugs, allowed the epilepsy to be effectively controlled without recurrence. Patients with episodes of NKH epilepsy increased significantly with hyperglycemia. Raising awareness of the disease, early diagnosis, and very early lowering the hyperglycemia levels, can effectively control the seizures. Lowering blood glucose is an effective way to control blood glucose levels. Material and methods This research has been approved by the ethics committee of the Second Hospital affiliated to Nantong University. Informed consent has been obtained and this investigation has been conducted according to the principles expressed in the Declaration of Helsinki. Thirteen cases of NKH-related epileptic seizures were treated from December 2009 to October 2014 in our neurosurgery department. Among them, 8 were males, and 5 females, aged 45–80 years old (mean age: 54 ± 2 years old). Their diabetes duration was bet Continue reading >>

Diabetic Seizures – What Are They? Symptoms, Causes, And Treatments

Diabetic Seizures – What Are They? Symptoms, Causes, And Treatments

A diabetic seizure is a serious medical condition and without emergency treatment, it has proven to be fatal. Extremely low levels of sugar in the diabetic’s blood cause these seizures. That is why it is so important for those who have diabetes to monitor and control their blood sugar. What Are the Causes? A number of different things can actually cause a diabetic seizure to occur. It could happen because too much insulin is injected, or because the diabetic did not eat right after taking insulin. Some of the other potential causes include not eating meals regularly or drinking too much alcohol. Even certain oral diabetes medications can make the body produce excess insulin. Those who are exercising too much without taking into account how this will affect their insulin levels will also be at a greater risk of suffering a diabetic stroke. No matter what causes the seizure, it is always a medical emergency and those who have one need immediate medical attention. What Are the Symptoms? When entering the first stages of a diabetic seizure, the person may exhibit a number of different symptoms. Some of the most common symptoms include: Sweating Clamminess Drowsiness Confusion Bodily shakes Hallucinations Rapid and unexpected emotional changes Weakness in the muscles Anxiety Vision changes Loss of ability to speak clearly After these initial symptoms, the next phase of symptoms begin and the danger level rises. Now, the person may stare into space and be non-communicative and uncontrollable body movements and contractions of the muscles may occur. In some cases, the diabetic will be unaware of the movements and may even fall into unconsciousness. What Is the Prevention and Treatment? The best way to deal with this problem is by ensuring it does not occur in the first place Continue reading >>

Why Does My Dog Have Seizures

Why Does My Dog Have Seizures

A dog may seizure for any number of reasons. Just because a dog has a seizure does not mean that the dog has epilepsy. Just because I have a running nose does not mean that I have a cold. I could have a reaction to someone's perfume, I could have a sinus infection, I could have allergies, I could have ... . There are many tests to determine what exactly I have that is causing my running nose. However, there is no test in the medical industry for the existence of epilepsy (primary, inherited or idiopathic). To determine whether a dog has epilepsy or something else, a veterinarian or neurologist arrives at their diagnosis by a process of elimination. They determine what is not and then, hopefully, come to a logical conclusion as to what it is. The following is a list of conditions which can cause seizures in dogs. Each condition is discussed in the following sections: 6. hyper' and 'hypo' Conditions Hyperglycemia Hypoglycemia Hypoxia or Hypoxemia Hepatic Encephalopathy or Liver Disease Renal (kidney) disease Hyperkalemia Hyperlipoproteinemia "garbage" poisoning) Tick Bites Toxoplamosis (Toxo) loss of vision motor coordination seizures Disease Process Pressure Red _BC_ (cmm) White_BC_(cmm) Protein_mg/dl Normal <170 <5 <5 <25 Canine Distemper Encephalitis <120 23 19 49 Toxoplasma Encephalitis 256 2 17 94 Cuterebra Encephalitis - 10 280 98 Canine Primary Reticulosis - - 58 90 Focal Myelomalacia (infract) - 187 4 57 The text book Handbook of Veterinary Neurology, by Oliver and Lorenz, discusses the neurological exam. The first chapter is devoted to the discussion of the neurologic examination. In lay person's terms, the neurological exam evaluates how the nerves of the limbs are "talking" or communicating to the central nervous system and the brain and how the brain is respon Continue reading >>

How To Tell The Difference Between Hypoglycemia And Hyperglycemia

How To Tell The Difference Between Hypoglycemia And Hyperglycemia

Low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) can happen to just about anyone, but people with diabetes are more susceptible than most. It is important to recognize the symptoms of both issues so you can treat them properly. Hypoglycemia Symptoms (Low Blood Sugar) Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. This can happen when your body receives too much insulin within a short period of time. For example, someone new to insulin or oral glucose medication might accidentally take too much. But non-diabetics can also experience hypoglycemia as well. The most common symptoms are: Heart palpitations Fatigue Pale skin Shakiness Anxiety Sweating Hunger Irritability Tingling sensation around the mouth Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: Confusion, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as blurred vision Seizures Loss of consciousness Initial treatment of hypoglycemia is drinking juice, taking glucose tablets or anything that has high levels of sugar that can be quickly absorbed including less healthy options such as regular soft drinks and candy. The priority here is to get the blood sugar levels up as fast as possible. See also: Reversing diabetes Type-2 Hyperglycemia Symptoms (High Blood Sugar) Hyperglycemia is defined as having an abnormally high blood glucose. This condition is more common in Type 2, or non-insulin-dependent diabetics. It can also occur in Type 1 diabetics who consume carbohydrate-heavy foods without enough insulin afterwards. The most common symptoms are: Increased thirst Headaches Trouble concentrating Blurred vision Frequent peeing Fatigue ( Continue reading >>

Hyperglycemia (high Blood Sugar)

Hyperglycemia (high Blood Sugar)

Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>

Sweet Seizures – Epilepsia Partialis Continua

Sweet Seizures – Epilepsia Partialis Continua

Ragesh Panikkath MDa, Joaquin Abeal Lado MDb Correspondence to Ragesh Panikkath MD Email: [email protected] SWRCCC : 2013;1.(3):29-31 doi: 10.12746/swrccc2013.0103.032 ................................................................................................................................................................................................................................................................................................................................... Abstract Epilepsia partialis continua (EPC) refers to focal and recurrent seizures that happen every few seconds to minutes for extended periods of time. The most common causes of these seizures are stroke, Rasmussen’s encephalitis (in children), and viral encephalitis. Metabolic disorders, like hyperglycemic hyperosmolar state (HHS),infrequently cause EPC. Correction of the HHS stops the EPC and eliminates the need for antiepileptic drugs. Synaptic transmission in the central nervous system requires normal glucose concentrations. Hyperglycemia can lower the seizure threshold, and this possibly explains the development of seizures in patients with HHS. Keywords: Hyperglycemic hyperosmolar state, epilepsia partialis continua, focal seizures, diabetes ................................................................................................................................................................................................................................................................................................................................... Introduction Epilepsia partialis continua (EPC) refers to focal and recurrent seizures that happen every few seconds to minutes for extended periods of time.1 Cerebrovascular stroke, Rasmussen’s encephalitis, a Continue reading >>

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment protocols, as well as prompt identification and treatment of the precipitating cause, are important factors affecting outcome. The two most common life-threatening complications of diabetes mellitus include diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction in the net effective concentration of circulating insulin coupled with a concomitant elevation of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes. DKA is reported to be responsible for more than 100,000 hospital admissions per year in the United States1 and accounts for 4–9% of all hospital discharge summaries among patients with diabetes.1 The incidence of HHS is lower than DKA and accounts for <1% of all primary diabetic admissions.1 Most patients with DKA have type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness.2 Contrary to popular belief, DKA is more common in adults than in children.1 In community-based studies, more than 40% of African-American patients with DKA were >40 years of age and more than 2 Continue reading >>

Magnetic Resonance Imaging Features In Seizures Associated With Nonketotic Hyperglycemia

Magnetic Resonance Imaging Features In Seizures Associated With Nonketotic Hyperglycemia

1 Department of Neurology, China-Japan Union Hospital, Jilin Univetsity, Changchun, China 2 Department of Radiology, China-Japan Union Hospital, Jilin Univetsity, Changchun, China 3 Department of Thoracic Surgery, China-Japan Union Hospital, Jilin Univetsity, Changchun, China Date of Submission 29-May-2013 Date of Decision 11-Jun-2013 Date of Acceptance 09-Oct-2013 Date of Web Publication 22-Nov-2013 Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.121937 Sir, A 57-year-old female was admitted for episodic clonic jerks affecting her right face and arm, each episode lasting for approximately 2′ of 10 days duration. There was no improvement of jerks with carbamazepine, instead there was increase in the frequency (every 5′) and also developed right upper limb weakness. Past medical history was negative. Neurological examination revealed right hemiparesia. Admission serum glucose was 29.8 mmol/L with no ketone bodies in the urine; serum sodium was 133.8 mmol/L and potassium was 3.5 mmol/L; blood urea nitrogen was 6.0 mmol/L and calculated serum osmolality was 310.4 mmol/L. Admission computed tomography was normal. Electroencephalography (EEG) revealed inter-ictal epileptiform discharges around the left central sulcus [Figure 1]a-c. Brain magnetic resonance imaging (MRI) [Figure 2] done on day 2 of admission showed subcortical hypointensity signal changes in the left parietal region on T2-weighted (T2-W), fluid attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI). Apparent diffusion coefficient (ADC) map showed isointensity in the corresponding region. Overlying cortical showed hyperintensity on FLAIR, DWI sequences and hypointensity on ADC map. The ADC values in cortical and subcortical lesions were lower than contralatera Continue reading >>

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