Characteristic MR findings in seizures associated with nonketotic hyperglycemia (NKH): diagnostic value of contrast enhanced FLAIR imaging (CE-FLAIR)

Nonketotic hyperglycemia (NKH) have been reported to induce seizures, and may cause transient signal changes on MRI. The aim of our study was to describe the characteristic MRI abnormalities in patients with NKH complicated with seizures and to evaluate the diagnostic value of CE-FLAIR. We retrospectively studied MRI abnormalities in 10 patients with seizures associated with NKH. The MRI abnormalities observed acutely were focal subcortical hypointensities on T2WI/FLAIR imaging in all patients with overlying cortical hyperintensities in 2 patients. Focal overlying cortical or leptomeningeal enhancement on CE-T1WI or CE-FLAIR was observed in all patients. CE-FLAIR was superior to CE-T1WI for detecting characteristic leptomeningeal enhancement. Although these MRI abnormalities pose a broad differential diagnosis, recognition of these radiologic abnormalities in NKH is important in restricting unwarranted investigations and to institute early therapy.

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