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Endocrine Abstracts (2019) 63 P1036 | DOI: 10.1530/endoabs.63.P1036

Departement of Diabetology, Endocrinology, Metabolic Diseases and Nutrition Arrazi Hospital, Mohammed VI, Marrakech, Morocco.


Introduction: When hypoglycemia is deep and repeated, it can induce various neurological disorders, including epileptic seizures. The link between hypoglycemia and epileptic phenomena is complex and poorly explained. We report 3 cases of epilepsy induced by repeated episodes of deep hypoglycemia.

Cases report: Mr D.M, 48 years old, with a history of 3 episodes of hypoglycemic coma, admitted for status epilepticus with a blood glucose level of 0.4 g/l; cerebral CT was normal. The encephalogram showed a slowing of the background rhythm with paroxysmal fronto-central bilateral anomalies. Biological test shows endogenous hypersecretion of insulin; echoendoscopy revealed an hypoechogenicity of 2 cm/2.5 cm at the head of pancreas. The second case is a 38-year-old patient treated for epilepsy for 2 years, admitted for a major generalized tonic-clonic seizure with left hemiplegia. MRI brain was normal, glycemia was at 0.3 g/l, insulin levels and peptide C were too high, an Octreoscan is required; an endocrine tumor of the pancreas secreting insulin is strongly suspected in these two patients. The third case is a 22-year-old patient, diabetic type 1, receiving insulin for 6 years, he has a history of hypoglycemic coma and he is hospitalized for a new episode revealed by generalized tonic-clonic seizures. The encephalogram showed a slowing of the background rhythm with paroxysmal fronto-central bilateral anomalies. Cerebral MRI showed an hypersignal in T1 and T2 of the basal ganglia.

Discussion: The deep hypoglycemia can induce convulsive crises as far as it can predisposes to the development of epileptogenic foci. The induced seizures are mainly generalized and tonic-clonic and the described abnormalities predominate in the frontal and temporal lobes, which joins the cases of our three patients.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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