Aphasic status epilepticus complicating hyperosmolar hyperglycaemic state.
Omar Bokhari, Sarah Alqhtani, Laila Alqahtani et al.
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Case in brief
A 66-year-old man with type 2 diabetes presented with progressive speech decline and impaired coordination after a fall. EEG confirmed non-convulsive status epilepticus, and MRI revealed transient left temporal changes and later hippocampal atrophy. Treatment with insulin and levetiracetam resulted in significant recovery, illustrating the potential reversibility of aphasic status epilepticus in the context of hyperosmolar hyperglycaemic state.
Diagnostic / clinical pearl
Clinicians should consider hyperosmolar hyperglycaemic state as a reversible cause of aphasic status epilepticus, especially in patients with diabetes presenting with language disturbances.
Why it matters
This case highlights the diverse neurological manifestations of uncontrolled diabetes, emphasizing the need for awareness of such complications in clinical practice.