A Case of Aphasic Seizure as a Manifestation of Nonketotic Hyperglycemia in a Patient Undergoing Peritoneal Dialysis

Abstract

Peritoneal glucose absorption in peritoneal dialysis causes hyperglycemia. Nonketotic hyperglycemia (NKH) includes hyperosmolar hyperglycemic state, which refers to a condition that includes hyperglycemia, hyperosmotic pressure, and dehydration without severe acidosis. NKH is associated with various types of epileptic seizures, but aphasic seizure as a neurological complication of NKH is very rare. Here we report a case of aphasic seizure in a patient with NKH who underwent peritoneal dialysis. A 57-year-old man who had been undergoing peritoneal dialysis visited our hospital with the chief complaint of aphasia. His magnetic resonance imaging scan was normal, but his electroencephalography showed frequent generalized delta slow activity as well as epileptiform discharges originating from the left frontotemporal lobe. His dialysis modality was switched to hemodialysis and he was started on insulin for glucose control. The latter resulted in the disappearance of his seizures and of his aphasia.