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カワジリ スミヒロ
KAWAJIRI Sumihiro
河尻 澄宏 所属 医学部 医学科（附属東洋医学研究所） 職種 准教授 |
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| 論文種別 | 症例報告 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Occipital lobe seizures and subcortical T2 and T2* hypointensity associated with nonketotic hyperglycemia: a case report. |
| 掲載誌名 | 正式名：Journal of medical case reports 略 称：J Med Case Rep ISSNコード：17521947/17521947 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 10(1),pp.228 |
| 著者・共著者 | Sasaki Fuyuko, Kawajiri Sumihiro, Nakajima Sho, Yamaguchi Ai, Tomizawa Yuji, Noda Kazuyuki, Hattori Nobutaka, Okuma Yasuyuki |
| 発行年月 | 2016/08 |
| 概要 | BACKGROUND:Nonketotic hyperglycemia often causes seizures. Recently, seizures associated with nonketotic hyperglycemia have been found to be associated with subcortical T2 hypointensity on magnetic resonance imaging, especially in the occipital lobes. However, the mechanism remains unclear, although iron accumulation is suggested. We present a case of occipital lobe seizures associated with nonketotic hyperglycemia supporting the hypothesis that the mechanism of subcortical T2 hypointensity is iron accumulation using gradient-echo T2*-weighted magnetic resonance imaging.CASE PRESENTATION:A 65-year-old Japanese man complained of intermittent pastel-colored flashing lights. On neurological examination, he also had lower right-side quadrant hemianopia. No other abnormal neurological findings were found. On laboratory analysis, his blood glucose level was 370 mg/dL, HbA1c was 11.4 %, and serum osmolarity was 326 mOsm/L. No ketones were detected in urine. A magnetic resonance imaging scan of his head showed subcortical T2 and T2* hypointensity in his left occipital lobe. Single-photon emission computed tomography with I123-N-isopropyl-iodoamphetamine revealed hyperperfusion in the left dominant occipital lobe. These magnetic resonance imaging abnormalities resolved during clinical recovery and treatment to control his blood sugar level. Therefore, a diagnosis of occipital lobe seizures associated with nonketotic hyperglycemia was made.CONCLUSIONS:To the best of our knowledge, this is the first case of occipital lobe seizures associated with nonketotic hyperglycemia supporting the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2*-magnetic resonance imaging. |
| DOI | 10.1186/s13256-016-1010-8 |
| PMID | 27520801 |