A Case of Undiagnosed Diabetes Mellitus with Alcohol Dependence Presenting as Epilepsia Partialis Continua OD04-OD05
Dr. Amrita Sarkar,
Senior Resident, Department of Community Medicine, NEIGRIHMS, Shillong-793018, Meghalaya, India.
Non-Ketotic Hyperglycaemia (NKH) or hyperosmolar hyperglycaemic state is a rare cause of Epilepsia Partialis Continua (EPC) or any other types of seizures. However, it poses a diagnostic challenge when a previously undiagnosed diabetic patient presents with partial seizures owing to NKH. We report a 53-year-old male, alcohol dependent patient who was not a known diabetic, presenting with jerky movements of the right arm. He was initially started on phenytoin without any signs of improvement. His blood glucose was 900 mg/dL. He was treated in lines of NKH induced partial seizure with regular insulin infusion and the anti-epileptics were stopped. He showed dramatic improvement with control of blood glucose. We recommend that elderly patients presenting with first episode of partial seizure should be investigated for metabolic disorders along with imaging studies. Also, partial seizures in elderly patients with alcohol dependence should arouse suspicion for metabolic disorders.