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Abstract
Spectrum of the neurological deficits in non-ketotic hyperglycemia and hyperosmolar hyperglycemic state (HHS) ranges widely among patients and can have any presentation from focal seizures, epilepsia partialis continua, chorea-hemiballismus syndrome, hemiparesis, hemianopia to mental obtundation and coma. Here we report a case of HHS which presented with Left Homonymous Hemianopia as the only initial presentation. Symptoms slowly resolved over the course of two weeks by administration of insulin and normalizing the glucose.
Highlights
Hyperglycemic Hyperosmolar State (HHS) is an acute complication of diabetes mellitus (DM) and carries significant morbidity and mortality
Many etiologies have been described for the Homonymous Hemianopia (HH) in the literature, including infarction, hemorrhage, demyelination, neoplasm, inflammation and infection [1]
Homonymous Hemianopia has been previously reported as a rare complication of HHS or non-ketotic hyperglycemia
Summary
Hyperglycemic Hyperosmolar State (HHS) is an acute complication of diabetes mellitus (DM) and carries significant morbidity and mortality. HHS is a syndrome defined by severe hyperglycemia, hyperosmolarity, and dehydration without ketoacidosis. Decreased cerebral perfusion from dehydration may cause neurologic signs such as focal neurologic deficits, visual acuity disturbances, delirium, and coma. Many etiologies have been described for the Homonymous Hemianopia (HH) in the literature, including infarction, hemorrhage, demyelination, neoplasm, inflammation and infection [1]. HH as a presentation of hyperglycemia or HHS is very uncommon and most of the reported cases have similarities, but major differences as well. Correcting the hyperglycemia remains the ultimate therapy for this condition
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