Seizure: European Journal of Epilepsy
Volume 19, Issue 6 , Pages 359-362 , July 2010

Occipital lobe seizures related to marked elevation of hemoglobin A1C: Report of two cases

  • Wan-Ling Hung

      Affiliations

    • Division of Neurology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
    • ,
  • Peiyuan F. Hsieh

      Affiliations

    • Division of Neurology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
    • School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
    • Graduate Institute of Biomedicine and Biomedical Technology, National Chi Nan University, Nantou Hsien, Taiwan, ROC
    • Corresponding Author InformationCorresponding author at: Division of Neurology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Taichung-Kang Rd., Taichung 407, Taiwan, ROC. Tel.: +886 4 2359 2525x3021; fax: +886 4 2358 4403.
    • ,
  • Yi-Chung Lee

      Affiliations

    • Division of Neurology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
    • School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
    • ,
  • Ming-Hong Chang

      Affiliations

    • Division of Neurology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
    • School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

Received 12 July 2009 ,Revised 26 January 2010 ,Accepted 20 May 2010.

  • Image Result

    EEG, brain MRI, and SPECT of patient 1. (A) EEG on hospital day 2. A seizure starts as right occipital β activity of gradually increasing amplitude and decreasing frequency (arrow, upper segment). The

    EEG, brain MRI, and SPECT of patient 1. (A) EEG on hospital day 2. A seizure starts as right occipital β activity of gradually increasing amplitude and decreasing frequency (arrow, upper segment). The end of the seizure is shown in the lower segment. The clinico-EEG seizure was recorded during drug-induced light sleep. (B) Brain MRI on hospital day 3, with T1-weighted image, T2-weighted image, and fluid-attenuated inversion-recovery image (FLAIR) in sequence. There are increased thickness and signal intensity over the cortex of the right occipital lobe and right mesial temporal lobe as well as underlying subcortical hypointensity in the T2-weighted image. (C) Tc-99m HMPAO SPECT showing hyperperfusion in the right occipital lobe on hospital day 5.

  • Image Result
    EEG and brain MRI of patient 2. (A) EEG on hospital day 1. The upper segment shows interictal normal awake EEG. The lower segment recorded during drug-induced light sleep shows an interictal epileptif

    EEG and brain MRI of patient 2. (A) EEG on hospital day 1. The upper segment shows interictal normal awake EEG. The lower segment recorded during drug-induced light sleep shows an interictal epileptiform discharge consisting of a medium-voltage beta activity for two seconds in the right occipital region (arrow). (B) Brain MRI on hospital day 2, with T1-weighted image, T2-weighted image, and FLAIR in sequence. There is a relatively low signal over the subcortical area of the right occipital lobe in the T2-weighted image.

PII: S1059-1311(10)00110-X

doi: 10.1016/j.seizure.2010.05.006

Seizure: European Journal of Epilepsy
Volume 19, Issue 6 , Pages 359-362 , July 2010

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