Abstract

AbstractFocal motor neurological disturbances may be the presenting symptom of diabetic non‐ketotic hyperglycaemia (Refs 1–12). In such circumstances, the hyperglycaemia is not severe and serum osmolality is characteristically only mildly elevated. The sodium is usually normal or slightly raised. Further metabolic deterioration is reported to result in cessation of seizure activity and development of coma. Such convulsions are not seen in diabetic ketoacidosis, possibly because ketones have an anti‐epileptic effect. We report a case of focal motor epilepsy in a patient presenting with severe hyperglycaemia, marked hyponatraemia and acidosis. Ketones were present in both serum and urine.

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