Situation (hyperglycemia)-related non-convulsive status epilepticus detected by 1.5-Tesla arterial spin labeling perfusion imaging in a patient with newly diagnosed diabetes during a neurological emergency

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  • Yokomizo Akifumi
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Morioka Takato
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Mugita Fumihito
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Inoha Satoshi
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Akiyama Tomoaki
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Shimogawa Takafumi
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Mukae Nobutaka
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Sakata Ayumi
    Department of Clinical Laboratory, Kyushu University Hospital, Fukuoka, Fukuoka, Japan Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Shigeto Hiroshi
    Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Yoshimoto Koji
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan

Description

<p>Situation-related non-convulsive status epilepticus (SR-NCSE) is a type of NCSE that is associated with various situations, including hyperglycemia. A 67-year-old woman with no prior history of type 2 diabetes mellitus visited our emergency room, experiencing difficulty typing on her mobile phone for approximately 2 h. Her blood glucose level was 334 mg/dL. 1.5-Tesla arterial spin labeling (ASL) perfusion magnetic resonance imaging, performed 40 min after her arrival, revealed presumed ictal hyperperfusion in the left parietal lobe. SR-NCSE associated with hyperglycemia was highly suspected, and she was immediately administered with insulin and antiseizure medications. The patient’s symptoms improved promptly. An electroencephalogram performed approximately 2 days later failed to reveal paroxysmal discharges. During neurological emergencies, ASL has the advantage of taking less time to perform than EEG, and we believe that ASL is useful in diagnosing SR–NCSE as well as structural focal NCSE when EEG cannot be performed.</p>

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