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Epileptic Disorders

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Location-atypical lesions in non-ketotic hyperglycemic epilepsy: expanding the clinico-radiographic phenotype Volume 24, issue 6, December 2022

Figure 1.

(A-F) A 47-year-old woman with headache and seizures in the setting of non-ketotic hyperglycemia. On initial presentation, T2-weighted (A) and FLAIR (B) images revealed a T2/FLAIR hypointense area within the right anterior temporal lobe associated with restricted diffusion on the ADC image (C). Two months following her initial presentation, there was interval development of T2 (D) / FLAIR (E) hyperintensity within the previously noted area of T2/FLAIR hypointensity in the anterior right temporal lobe with development of facilitated diffusion in this region, best visualized on the ADC image (F).

Figure 2.

(A-C) A 57-year-old woman presented with altered mental status and seizures in the setting of non-ketotic hyperglycemia. T2 (A) and FLAIR (B) images demonstrate an area of T2/FLAIR hypointensity within the left frontotemporal lobes, which is associated with restricted diffusion, best visualized on the ADC image (C).

Figure 3.

(A-C) A 60-year-old woman who presented with transient confusional spells was found to have seizures in the setting of non-ketotic hyperglycemia. T2 (A) and FLAIR (B) images showed an area of hypointensity in the left middle central gyrus, with mild diffusion restriction, best appreciated on the ADC image (C). Nine months following her initial presentation, there was interval resolution of these changes, as seen on the T2-weighted (D), FLAIR (E), and ADC (F) images.

Figure 4.

(A-F) A 56-year-old man with right hand jerks in the setting of non-ketotic hyperglycemia. On initial presentation, T2-weighted (A) and FLAIR (B) images revealed a T2/FLAIR hypointensity within the left parietal lobe with corresponding restricted diffusion (C) on the ADC image. Seven months after this presentation with correction of hyperglycemia, there was interval resolution of these changes, as seen on the T2-weighted (D), FLAIR (E), and ADC (F) images.