Evidence map›Paper›PMID 40656454›Full record

ArticleFrontiers in neuroscience2025

Case Report: Role of hypoglycemia in seizure aggravation in a case of focal epilepsy: revealing a missing link between diabetes and dementia.

Hiroya Ohara, Masami Yamanaka, Kiyoko Inoue, Hironori Shimizu, Naohiko Iguchi, Keiko Tanaka, Abilash Valsala Gopalakrishnan, Balachandar Vellingiri, Masako Kinoshita

Abstract readCase Reports
In one paragraph

Article in Frontiers in neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Hiroya OharaDepartment of Neurology, Minaminara General Medical Center, Nara, Japan.
Masami YamanakaDepartment of Clinical Laboratory, Minaminara General Medical Center, Nara, Japan.
Kiyoko InoueDepartment of Clinical Laboratory, Yoshino Hospital, Nara, Japan.
Hironori ShimizuDepartment of Neurology, Nara Medical University School of Medicine, Nara, Japan.
Naohiko IguchiDepartment of Neurology, Minaminara General Medical Center, Nara, Japan.
Keiko TanakaDepartment of Animal Model Development, Brain Research Institute, Niigata University, Niigata, Japan.
Abilash Valsala GopalakrishnanDepartment of Biomedical Sciences, School of Bio Sciences and Technology (SBST), VIT, Vellore, Tamil Nadu, India.
Balachandar VellingiriDepartment of Zoology, Central University of Punjab, Bathinda, Punjab, India.
Masako KinoshitaDepartment of Neurology, National Hospital Organization Utano National Hospital, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: While low-frequency electroencephalographic (EEG) activity increases during hypoglycemia, the relationship between hypoglycemia and changes in epileptic activities has not been fully investigated. Recently, the American Clinical Neurophysiology Society's EEG Terminology 2021 defined criteria for Brief Potentially Ictal Rhythmic Discharges (BIRDs) including rhythmic fast activities. We evaluated the association between hypoglycemia and BIRDs. Methods: Data from a 27-year-old female with focal epilepsy and idiopathic hypoglycemia, who underwent scalp-recorded long-term video-EEG using the International 10-20 system with T1/T2 electrodes, were analyzed. Her anti-neuronal antibody test results were negative. EEG recordings over 6 h were retrospectively evaluated in longitudinal bipolar montages at 15 s per display screen. The number and duration of BIRDs were assessed in each 30 min epoch. Glucose levels were obtained using a flash glucose monitoring system, and the average glucose level for each epoch was calculated using the area under the curve (AUC), measured by pixel-counting software. The relationship between the number and duration of BIRD subtypes and average glucose levels was evaluated using cut-off values of 70, 60, and 50 mg/dL. Results: During the recording, the EEG showed focal slow activities, epileptic spikes, and BIRDs in the left temporal area, but no clinical or electrographic seizures were observed. The number of evolving BIRDs per epoch was significantly higher during more severe hypoglycemia when the cut-off values were set at 60 mg/dL (2.00 ± 0.71 vs. 0.38 ± 0.70, mean ± SD, Conclusion: Maintaining glucose levels above 60 mg/dL appears important for the early termination of epileptic rhythmic discharges. Individuals with diabetes are at high risk of Alzheimer's disease (AD), and hippocampal hyperactivity contributes to epileptic seizures, amyloid deposition, and disease progression. Fluctuations in blood glucose levels, including episodes of hypoglycemia, increase the risk of dementia. The present findings suggest a potential causative role of hypoglycemia in AD and propose a precise method to correlate glucose levels with brain activities.

Indexed as

Alzheimer’s diseaseBrief Potentially Ictal Rhythmic Dischargeselectroencephalographyflash glucose monitoringfocal epilepsyhypoglycemialong-term video-electroencephalography monitoringtemporal lobe epilepsy

Identifiers

PMID40656454
PMCPMC12245777

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.