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January 17, 2001

Diagnosis and Symptoms, Other Illnesses

Question from :

About three months ago, I was diagnosed with impaired glucose tolerance (IGT) after having complained of unusual symptoms following an epileptic seizure. I complained of feeling more tired than I usually do, and having my glucose levels shoot up to over 250 mg/dl [13.9 mmol/L]. I have brain damage in both of my temporal lobes and another place in the middle of my brain that I've had since birth. My doctor did some tests and finally declared me with having IGT only when I have a seizures. She gave me a prescription for a glucose meter, and some medicine to reduce the number of seizures I was having. She was really stumped about this because she had never heard of blood glucose levels going up so high during a seizure, and being normal the rest of the time. I do not have diabetes nor have I shown symptoms for it. Do people who have epilepsy caused by brain damage have their glucose levels rise when they have a seizure, and go back to normal about an hour later?

Answer:

I have never come across a story like this nor have my colleagues who I asked about it.

I think there are two possible answers. The first is that surely any episode of ‘stress’ can lead to rather prompt rise in blood sugar from counterregulatory hormone release. The other is a bit more esoteric because in PubMed I found a number of papers in which positron scanning had shown that in temporal lobe epilepsy, there was regional hypoglycemia in the brain. For example: in Wunderlich. et al. Epilepsy Res. 38:339,2000, the opening sentence is:

Patients with mesial temporal lobe epilepsy (mTLE) exhibit marked depressions of the regional cerebral glucose metabolism…

So, I suppose one might postulate that the high blood sugar might be a normal response to very localised cerebral hypoglycemia. I don’t know anything about whether your seizures really are temporal lobe epilepsy, just that you had damage there, nor do I know anything about what the episodes are like so its all just an intriguing guess. You should discuss this with your doctor.

MS