Crise d’épilepsie associée au Diabète : expérience du département de Médecine du CHU Gabriel Touré de Bamako, Mali.

Résumé

Introduction: Diabetes mellitus is the most common of the noncommunicable diseases and characterized by a high economic burden and numerous chronic complications. Epileptic seizures can be associated with diabetes but also be the revealing mode. The mechanism by which hyperglycemia without ketosis lead to seizures is poorly understood and probably due to several factors.

Patients and Methods: This is a retrospective study that took place over three years in the Department of Medicine of teaching Hospital of Gabriel Touré. We enrolled five patients in whom epileptic seizures were the revealing mode of diabetes. Most of our patients had a focal motor secondarily generalized seizures. Only one patient had an abnormal neurological examination. Brain CT-scan was abnormal in one patient with thalamic lacunar infarct image. The inter-ictal EEG was abnormal in four patients. All patients had high HbA1c with an average of 11.2% and an average capillary blood sugar of 3.3g/l (18.80 mmol/l). The cardiovascular risk factors found in our patients were one or association of hypertension, dyslipidemia and obesity.

Conclusion:Hyperglycemia remains a source of epileptic seizures, particularly in hyperglycemia without ketosis. Seizures can be the revealing mode of diabetes. The screening of hyperglycemia in epileptic seizures should be systematic in routine clinical practice.