Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Mar 6;9(7):1720-1727.
doi: 10.12998/wjcc.v9.i7.1720.

Hyperglycemic hemianopia: A case report

Xiao-Hui Xiang  1 , Jia-Jia Fang  1 , Mi Yang  1 , Guo-Hua Zhao  2
Affiliations
Case Reports

Hyperglycemic hemianopia: A case report

Xiao-Hui Xiang et al. World J Clin Cases. .

Abstract

Background: Nonketotic hyperglycemia (NKH) is characterized by hyperglycemia with little or no ketoacidosis. Diverse neurological symptoms have been described in NKH patients, including choreoathetosis, hemiballismus, seizures, and coma in severe cases. Homonymous hemianopia, with or without occipital seizures, caused by hyperglycemia is less readily recognized.

Case summary: We describe a 54-year-old man with NKH, who reported seeing round, colored flickering lights with right homonymous hemianopia. Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe, with decreased T2 signal of the white matter, restricted diffusion, and corresponding low signal intensity in the apparent diffusion coefficient map. He responded to rehydration and a low-dose insulin regimen, with improvements of his visual field defect.

Conclusion: Patients with NKH may present focal neurologic signs. Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.

Keywords: Case report; Homonymous hemianopia; Imaging manifestations; Nonketotic hyperglycemia; Occipital seizures.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Visual field over the central 30 degrees showed a right homonymous hemianopia.
Figure 2
Figure 2
Magnetic resonance imaging showed low signal intensity in the apparent diffusion coefficient map. A: Magnetic resonance imaging of the brain demonstrating isointensity on T1 sequence; B: Susceptibility weighted imaging; C: Left occipital subcortical T2; D: Fluid-attenuated inversion recovery hypointensity (orange arrow); E: Restricted diffusion; and F: Low signal intensity of the ADC map.
Figure 3
Figure 3
Magnetic resonance angiography imaging of the brain showed a mild stenosis. A: Magnetic resonance angiography demonstrating mild stenosis of the right posterior cerebral artery (orange arrow); and B: Arterial spin labeling showing decreased perfusion of the lesion (arrowhead).
See this image and copyright information in PMC

References

    1. Bacanu G, Anghelescu L, Mihailov E, Wilkomm I. [Hyperosmolar Diabetic Coma without Acidoketosis] Med Interna (Bucur) 1965;17:353–359. - PubMed
    1. Chung SJ, Lee JH, Lee SA, No YJ, Im JH, Lee MC. Co-occurrence of seizure and chorea in a patient with nonketotic hyperglycemia. Eur Neurol. 2005;54:230–232. - PubMed
    1. Singh BM, Strobos RJ. Epilepsia partialis continua associated with nonketotic hyperglycemia: clinical and biochemical profile of 21 patients. Ann Neurol. 1980;8:155–160. - PubMed
    1. Guisado R, Arieff AI. Neurologic manifestations of diabetic comas: correlation with biochemical alterations in the brain. Metabolism. 1975;24:665–679. - PubMed
    1. Maccario M. Neurological dysfunction associated with nonketotic hyperglycemia. Arch Neurol. 1968;19:525–534. - PubMed

Publication types

LinkOut - more resources