| Delayed diagnosis due to nonketotic hyperosmolar coma in patient with nonconvulsive status epilepticus |
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, , , , , |
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경상대학교 의과대학 내과학교실 |
| 증례 : 비케톤성 고삼투압성 혼수로 인해 늦게 진단된 비경련성 간질중첩증 1예 |
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황승환&#;홍세인&#;조동혁&#;강호철&#;정동진&#;정민영, , , , , |
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Department of Internal Medicine, Gyeong-Sang National University College of Medicine, Jinju, Korea |
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| Abstract |
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Different types of epilepsy can be accompanied with nonketotic hyperosmolar coma (NKHC). A 65 year-old woman, who suffered with recent polyuria, polydipsia and general weakness, presented with coma at the emergency room. She was diagnosed as NKHC associated with urinary tract infection, and she was treated with hydration, insulin infusion and parenteral antibiotics injection. Yet her mental state did not recover in spite of the laboratory improvement. The findings of brain computed tomography were otherwise not remarkable. Thereafter, electroencephalogram (EEG) was performed. Even though the EEG showed continuous multifocal spike-wave complexes with phase reversal in the frontal area, there were no convulsions. She was diagnosed as the nonconvulsive status epilepticus (NCSE). She was placed on intravenous phenytoin. Even with this treatment, she did not improve; sadly, she finally expired. To our knowledge, NKHC associated with NCSE has not yet been reported on in Korea. We report this case with a review of the other literatures.
In conclusion, we recommend performing the rapid EEG test for all NKHC patients who do not show improvement of their mental state after treatment.(Korean J Med 71:S1044-S1048, 2006)
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| Key Words:
Hyperosmolar hyperglycemic nonketotic coma, Epilepsy, Diabetes mellitus |
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