Abstract

In patients older than 50 years, a first seizure can reveal non-ketotic hyperglycemia, regardless of any previous history of diabetes mellitus. Partial motor seizures are observed in most cases, sometimes with epilepsia partialis continua. Plasma glucose levels are usually above 20 mmol/L, and serum osmolarity is normal or slightly elevated. The absence of ketoacidosis may promote the occurrence of seizures. EEG and neuroimaging between seizures are usually normal. Treatment involves correction of the hyperglycemia with insulin treatment and rehydration.

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