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Case Reports
. 2018 Oct 2:10:124-128.
doi: 10.1016/j.ebcr.2018.09.001. eCollection 2018.

Post-operative nonketotic hyperglycemic induced focal motor status epilepticus related to treatment with corticosteroids following standard anterior temporal lobectomy

Andrew Zillgitt  1 , Abdullah Alshammaa  2 , Muhammad Salim Kahn  2 , Sarah Madani  2 , Salman Zahoor  2 , Ellen L Air  3
Affiliations
Case Reports

Post-operative nonketotic hyperglycemic induced focal motor status epilepticus related to treatment with corticosteroids following standard anterior temporal lobectomy

Andrew Zillgitt et al. Epilepsy Behav Case Rep. .

Abstract

•Complications from standard ATL are uncommon and the use of post-operative corticosteroids may reduce complications.•Following standard ATL, FMSE was present after treatment with corticosteroids that resolved after blood sugar control.•After epilepsy surgery, corticosteroids should be used cautiously in people with comorbid diabetes mellitus.

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Figures

Fig. 1
Fig. 1
Interictal EEG; Right temporal sharp-and-wave discharge during stage 2 sleep. AP bipolar montage, TC 0.3, HFF 70 Hz, Sen 7 uV.
Fig. 2
Fig. 2
Ictal EEG; Right temporal lobe seizure, 30 seconds after clinical onset. AP bipolar montage, TC, 0.1, HFF 70 Hz, Sen uV.
Fig. 3
Fig. 3
A-B – Preoperative brain MRI (coronal FLAIR sequence); there is atrophy, loss of internal architecture, and increased FLAIR signal within the right mesial temporal structures and hippocampus.
Fig. 4
Fig. 4
A-C – Post-operative brain MRI (A – coronal magnetization-prepared rapid gradient-echo (MP-RAGE), B – axial MP-RAGE, C – sagittal MP-RAGE); there are post-surgical changes in the right temporal lobe without obvious structural abnormalities within the adjacent right frontal and temporal lobes.
Fig. 5
Fig. 5
Post-operative ictal EEG; Right fronto-central seizures, 15 seconds after EEG and clinical onset. AP bipolar montage, TC 0.1, HFF 70 Hz, Sen 7 uV.
Fig. 6
Fig. 6
Post-operative ictal EEG density spectral array (DSA) trend; there was a total of 17 focal motor seizures over this 6-hour time period; TC 0.1, HFF 70 Hz, Sen 7 uV.
See this image and copyright information in PMC

References

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