Generalized Status Epilepticus in a Patient with Acute-onset Type 1 Diabetes Mellitus Associated with Severe Kidney Dysfunction: A Case Report and Literature Review

Nobumasa Ohara; Ryo Koda; Hirofumi Watanabe; Noriaki Iino; Kazumasa Ohashi; Kenshi Terajima; Tetsutaro Ozawa; Yohei Ikeda; Hiroshi Sekiguchi; Hitomi Ohashi; Seigo Yamaguchi

doi:10.2169/internalmedicine.56.8304

CASE REPORTS

Generalized Status Epilepticus in a Patient with Acute-onset Type 1 Diabetes Mellitus Associated with Severe Kidney Dysfunction: A Case Report and Literature Review

Nobumasa Ohara, Ryo Koda, Hirofumi Watanabe, Noriaki Iino, Kazumasa Ohashi, Kenshi Terajima, Tetsutaro Ozawa, Yohei Ikeda, Hiroshi Sekiguchi, Hitomi Ohashi, Seigo Yamaguchi

Author information

Nobumasa Ohara
Department of Endocrinology and Metabolism, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Ryo Koda
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Hirofumi Watanabe
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Noriaki Iino
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Kazumasa Ohashi
Department of Respiratory Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Kenshi Terajima
Department of Neurology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Tetsutaro Ozawa
Department of Neurology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Yohei Ikeda
Department of Radiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Hiroshi Sekiguchi
Department of Emergency and Critical Care Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Hitomi Ohashi
Department of Emergency and Critical Care Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Seigo Yamaguchi
Department of Emergency and Critical Care Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan

Keywords: type 1 diabetes mellitus, generalized tonic-clonic status epilepticus, diabetic ketoacidosis, acute kidney injury, chronic kidney disease, electrolyte disturbance

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 15 Pages 1993-1999

DOI https://doi.org/10.2169/internalmedicine.56.8304

Details

Abstract

A 65-year-old Japanese man with advanced chronic kidney disease (CKD) developed acute-onset type 1 diabetes mellitus (T1D) that was associated with severe acute kidney injury and was manifested by generalized tonic-clonic status epilepticus. His seizures resolved without recurrence after correcting the diabetic ketoacidosis. Although hyperglycemia is an important cause of acute symptomatic seizure (ASS), patients with ketotic hyperglycemia develop ASS less frequently. In this T1D case with CKD, severe hyperglycemia in conjunction with other metabolic insults, such as uremia, hyponatremia, and hypocalcemia, probably provoked his seizure despite the severe ketonemia.

Corresponding author

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