Acute confusion and seizures in a 63-year-old woman

Abstract

A 63-year-old woman with a history of mild sensineural hearing loss, diabetes mellitus (diagnosed more than 30 years ago), and polyneuropathy with atrophy of the leg muscles and foot drop presented to the emergency room with acute confusion, cognitive impairment and two generalized tonic–clonic seizures. An initial CT scan was performed, which showed a hypodense lesion in the right temporal lobe. This was followed by a cranial MRI (Figs. 1 and 2).