Diabetic Ketoacidosis Causing Transient Homonymous Hemianopia and Generalized Seizure: A Case Report and Literature Review.

Abstract

Introduction: Neurologic complications of hyperglycemia are common. Cases of seizures and hemianopia related to nonketotic hyperglycemia have been reported but are rare with diabetic ketoacidosis.

Case presentation: We present clinical, laboratory, and radiologic findings in a patient with diabetic ketoacidosis associated with generalized seizure and homonymous hemianopia, with a literature review of reported cases.

Discussion: Neurologic complications of hyperglycemia are many, but seizure with hemianopia is most commonly associated with nonketotic hyperosmolar hyperglycemia rather than diabetic ketoacidosis.

Conclusions: Generalized seizure and retrochiasmal visual field defect are known neurological complications of diabetic ketoacidosis. Like nonketotic hyperosmolar hyperglycemia, these neurological symptoms are transient, and the structural changes in magnetic resonance imaging are usually reversible.