Skip to main content
SpringerLink
Log in

Seizures and Endocrine Disorders

  • Chapter
Seizures

Part of the book series: Current Clinical Neurology ((CCP))

  • 357 Accesses

Abstract

Derangement in endocrine homeostasis can result in many different neurological signs and symptoms (1). Seizures are a common neurological presentation of changes in endocrine function (Table 1), which may be difficult to control until the underlying etiology is uncovered and addressed. Hypoglycemia and hyperglycemia are important common defects of endocrine disorders encountered in clinical practice (2,3). Glucose is the primary energy substrate of the brain, and any disturbance of normal glucose concentration may cause altered cerebral function and result in irreversible neuronal damage if the process is prolonged. Seizures may also occur as a result of electrolyte imbalance secondary to primary endocrine disorders, such as hypocalcemia (4) from hypoparathyroidism and hyponatremia from primary adrenal insufficiency (5). Recognition and correction of the underlying metabolic disturbance are of utmost importance in the management of such cases (Table 2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Singer MM. Endocrine Emergencies. Med Clin North Am, 1971; 55: 1315–1329.

    PubMed  CAS  Google Scholar 

  2. Gilmore RL. Seizures associated with nonneurologic medical conditions. In The Treatment of Epilepsy: Principles and Practice,Wyllie, E (ed), Williams and Wilkins, pp. 654–665.

    Google Scholar 

  3. Delanty N, Vaughan JA. Medical causes of seizures. Lancet 1998; 352: 383–390.

    Article  PubMed  CAS  Google Scholar 

  4. Panagariya A, Sharma A, Chhabria H. Hypoparathyroidism—presenting as uncontrolled seizures. J Assoc Physicians India 1990; 38: 442 (abstract).

    PubMed  CAS  Google Scholar 

  5. Samaan NA. Hypoglycemia secondary to endocrine deficiencies. Endocrinol Metab Clin NAm 1989; 18: 145–153.

    CAS  Google Scholar 

  6. Schachter SC. Neuroendocrine aspects of epilepsy. Neurol Clin 1994; 12: 31–37.

    PubMed  CAS  Google Scholar 

  7. Cornford EM, Olendorf WH. Epilepsy and the blood brain barrier. Adv Neurol 1986; 44: 787–812.

    PubMed  CAS  Google Scholar 

  8. Wasterlain CG, Dwyer BE. Brain metabolism during prolonged seizures in neonates. Adv Neurol 1983; 34: 241–260.

    PubMed  CAS  Google Scholar 

  9. Whiting S, Camfield P, Arab D, Salisbury S. Insulin-dependent diabetes mellitus presenting in children as frequent, medically unresponsive, partial seizures. J Child Neurol 1997; 12: 178–180.

    Article  PubMed  CAS  Google Scholar 

  10. Malouf R, Brust JC. Hypoglycemia: causes, neurological manifestations, and outcome. Ann Neurol 1985; 1985: 421–430.

    Article  Google Scholar 

  11. Hennis A, Corbin D, Fraser H. Focal seizures and non-ketotic hyperglycemia. J Neurol Neurosurg Psychiatry 1992; 55: 195–197.

    Article  PubMed  CAS  Google Scholar 

  12. Harden CL, Rosenbaum DH, Daras M. Hyperglycemia presenting with occipital seizures. Epilepsia 1991; 32: 221–224.

    Article  Google Scholar 

  13. Duncan MB, Jabbari B, Rosenberg ML. Gaze-evoked visual seizures in non-ketotic hyperglycemia. Epilepsia 1991; 32: 221–224.

    Article  PubMed  CAS  Google Scholar 

  14. Carril JM, Guijarro C, Portocarrero JS, et al. Speech arrest as manifestation of seizures in non-ketotic hyperglycemia. Lancet 1992; 340: 1227.

    Article  PubMed  CAS  Google Scholar 

  15. Messing RO, Simon RP. Seizures as a manifestation of systemic disease. Neurol Clin 1986; 4: 563–579.

    PubMed  CAS  Google Scholar 

  16. Warner DS, Gionet TX, Todd MM, McAllister AM. Insulin-induced normoglycemia improves ischemic outcome in hyperglycemic rats. Strokes 1992; 23: 1775–1781.

    Article  CAS  Google Scholar 

  17. Uchino H, Smith ML, Bengzon J, Lundgren J, Siesjo BK. Characteristics of postischemic seizures in hyperglycemic rats. J Neurol Sci 1996; 139: 21–27.

    Article  PubMed  CAS  Google Scholar 

  18. Li PA, Shamloo M, Smith ML, Katsura K, Sisjo BK. The influence of plasma glucose concentrations on ischemic brain damage is a threshold function. Neurosci Lett 1994; 177: 63–65.

    Article  PubMed  CAS  Google Scholar 

  19. Ehrlich RM. Hypoglycemia in infancy and childhood. Arch Dis Child 1971; 46: 716–719.

    Article  PubMed  CAS  Google Scholar 

  20. Doherty GM, Doppman JL, Shawker TH, et al. Results of a prospective strategy to diagnose, locate, and resect insulinomas. Surg Gynecol Obstet 1991; 163: 509–512.

    Google Scholar 

  21. Ginsberg-Fellner F, Rayfield EJ. Metabolic studies in a child with a pancreatic insulinomas. Am J Diseases Child 1980; 134: 64–67.

    CAS  Google Scholar 

  22. Katz LB, Aufses AH, Rayfield E, Mitty H. Preoperative localization and intraoperative glucose monitoring in the management of patients with pancreatic insulinoma. Surg Gynecol Obstet 1986; 163: 509–512.

    PubMed  CAS  Google Scholar 

  23. Fowler DL, Wood WG, Kontz PG. Endogenous hyperinsulinism. J Gastroenterol 1980; 74: 321–327.

    CAS  Google Scholar 

  24. van Heerden JA, Edis AJ, Service FJ. The surgical aspects of insulinomas. Ann Surg 1979; 189: 677–682.

    Article  PubMed  Google Scholar 

  25. Bjerk HS, Kelly RE, Geffner ME, Fonkalsurd EW. Surgical management of islet cell dysmaturation syndrome in young children. Surg Gynecol Obstet 1990; 171: 321–325.

    Google Scholar 

  26. Desai MP, Khatri JV. Persistent hyperinsulinemic hypoglycemia of infancy. Indian Pediatr 1998; 35: 317–328.

    PubMed  CAS  Google Scholar 

  27. Service FJ, Dale AJ, Jiang AS. Insulinoma. Mayo Clin Proc 1976; 51: 417–427.

    PubMed  CAS  Google Scholar 

  28. Lovvorn HN, Nance ML, Ferry RJ, et al. Congenital hyperinsulinism and the surgeon: lessons learned over 35 years. J Surg 1999; 34: 786–792.

    Google Scholar 

  29. Telander RL, Wolf SA, Simmons PS, Zimmerman D, Haymond MW. Endocrine disorders of the pancreas and adrenal cortex in pediatric patients. Mayo Clin Proc 1986; 61: 459–466.

    PubMed  CAS  Google Scholar 

  30. Chiarelli F, Verrotti A, Catino M, Sabatino G, Pinelli L. Hypoglycemia in children with type I diabetes mellitus. Acta Paediatr 1999; 88: 31–34.

    Article  CAS  Google Scholar 

  31. Arieff AI, Doerner T, Zelig H, Massry S. Mechanisms of seizures and coma in hypoglycemia. J Clin Invest 1974; 54: 654–663.

    Article  PubMed  CAS  Google Scholar 

  32. Wayne EA, Booth F, Teenbein M. Focal neurologic deficits associated with hypoglycemia in children with diabetes. J Pediatr 1990; 117: 575–577.

    Article  PubMed  CAS  Google Scholar 

  33. Soltesz G, Ascadi G. Association between diabetes, severe hypoglycemia, and electroencephalogarphic abnormalities. Arch Dis Child 1989; 64: 992–996.

    Article  PubMed  CAS  Google Scholar 

  34. Oztas B, Camurcu S. Blood brain barrier permiability after electrically induced seizures in normoglycemic, hypoglycemic and hyperglycemic rats. Psychiatry Res 1989; 29: 151–159.

    Article  PubMed  CAS  Google Scholar 

  35. Panickar KS, Purushotham K, Rajakumar G, Simpkins W. Hypoglycemia-induced seizures reduce cyclic AMP response element binding protein levels in rat hippocampus. Neuroscience 1998; 83: 1155–1160.

    Article  PubMed  CAS  Google Scholar 

  36. De Vivo DC, Malas KL, Leckie MP. Starvation and seizures; observation of the electroconvulsive threshold and cerebral metabolism of the starved adult rat. Arch Neurol 1975; 32: 755–760.

    Article  Google Scholar 

  37. Ferner, RE, Neil AJ, Jiang AS. Sulfonylureas and hypoglycemia, Br Med J Clin Res Ed 1988; 296: 949–950.

    Article  PubMed  CAS  Google Scholar 

  38. Ntyonga-Pono M.P. Addison’s disease revealed by hypoglycemic convulsion. Med Trop 1997; 57: 311–312.

    CAS  Google Scholar 

  39. Samantray SK. Fatal hypoglycemia: the sole presentation of Addison’s disease. Med JAustralia 1977; 2: 304.

    CAS  Google Scholar 

  40. Agura ED. Seizure in a normal marrow donor: Addison’s disease unmasked. Bone Marrow Transplant 1994; 13: 215–216.

    PubMed  CAS  Google Scholar 

  41. Thomas ET, Rooke D, Kvale WE. The neurologist’s experience with pheochromocytoma. J Am Med Assoc 1996; 197: 100–104.

    Google Scholar 

  42. Devinsky O, Price BH, Cohen SI. Cardiac manifestations of complex partial seizures. Am J Med 1986; 80: 195–202.

    Article  PubMed  CAS  Google Scholar 

  43. Ehrlich RM. Hypoglycemia in infancy and childhood. Arch Dis Child 1971; 46: 716–719.

    Article  PubMed  CAS  Google Scholar 

  44. Tonner DR, Schlechte JA. Neurologic complications of thyroid and parathyroid disease. Med Clin North Am 1993; 77: 251–263.

    CAS  Google Scholar 

  45. Smith DL, Looney TJ. Seizures secondary to thyrotoxicosis and high dosage Propranolol therapy. Arch Neurol 1983; 40: 457–458.

    Article  PubMed  CAS  Google Scholar 

  46. Primavera A, Brusa G, Novello P. Thyrotoxic encephalopathy and recurrent seizures. Eur Neurol 1990; 30: 186–188.

    Article  PubMed  CAS  Google Scholar 

  47. Aiello DP, DuPlessis AJ, Pattishall AC, Kulin HE. Thyroid storm: presenting with coma and seizures in 13 year old girl. Clin Pediatr 1989; 28: 571–574.

    Article  CAS  Google Scholar 

  48. Rangel-Guerra R, Martinez HR, Garcia-Hernandez P, et al. Epilepsy and thyrotoxicosis in a 4-year-old boy. Revisita Invest Clin 1992; 44: 109–113.

    CAS  Google Scholar 

  49. Radetti G, Dordi B, Mengarda G, Biscaldi I, Larizza D, Severi F. Thyrotoxicosis presenting with seizures and coma in two children. Am J Dis Child 1993; 1147: 925–927.

    Google Scholar 

  50. Tonner DR, Schlechte JA. Neurologic complications of thyroid and parathyroid disease. Med Clin North Am 1993; 77: 251–263.

    PubMed  CAS  Google Scholar 

  51. Bryce GM, Poyner F. (1992) Myxoedema presenting with seizures. Postgrad Med J 1992; 68: 35–36.

    Article  Google Scholar 

  52. Bostantjopoulou S, Zafiriou D, Katsarou Z, Kazis A. Hashimoto’s encephalopathy: clinical and laboratory findings. Functional Neurol 1996; 11: 247–251.

    CAS  Google Scholar 

  53. Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baugartner R, Hess CW. Encephalopathy associated with Hashimoto’s thyroiditis: diagnosis and treatment. J Neurol 1996; 243: 585–593.

    Article  PubMed  CAS  Google Scholar 

  54. Henchey R, Cibula J, Helveston W, Malone J, Gilmore RL. Electroencephalographic findings in Hashimoto’s encephalopathy. Neurology 1995; 45: 977–981.

    Article  PubMed  CAS  Google Scholar 

  55. Shaw PJ, Walls TJ, Newman PK, Cleland PG, Cartlidge NE. Hashimoto’s encephalopathy: a steroid responsive disorder associated with high anti-thyroid antibody titers. Neurology 1991; 41: 228–233.

    Article  PubMed  CAS  Google Scholar 

  56. Ghika-Schmid F, Ghika J, Regli F, et al. Hashimoto’s myoclonic encepahlopathy: an underdiagnosed treatable condition? Movement Disorders 1996; 11: 555–562.

    Article  PubMed  CAS  Google Scholar 

  57. Peschen-Rosib R, Schabet M, Dichgans J. Manifestation of Hashimoto’s encephalopathy years before the onset of thyroid disease. Eur Neurol 1999; 41: 78–84.

    Google Scholar 

  58. Henchey R, Cibula J, Helveston W, Malone J, Gilmore RL. Electrographic findings in Hashimoto’s encephalopathy. Neurology 1995; 45: 977–981.

    Article  PubMed  CAS  Google Scholar 

  59. Vanconcellos E, Pina-Garza JE, Fakhoury T, Fenichel GM. Pediatric Manifestations of Hashimoto’s encephalopathy. Pediatr Neurol 1999; 20: 394–398.

    Article  Google Scholar 

  60. Desai J, Wadai N. Hashimoto’s encephalopathy. J Neurol Sci 1999; 163: 202–203.

    Article  PubMed  CAS  Google Scholar 

  61. Ishii K, Hayashi A, Tamaoka A, Usuki S, Mizusawa H, Shoji S. Case report: Thyrotropin releasing hormone induced myoclonus and tremor in a patient with Hashimoto’s encepahlopathy. Am J Med Sci 1995; 310: 202–205.

    Article  PubMed  CAS  Google Scholar 

  62. Liao KK, Wang SJ, Lin KP, Tsai CP. Myoclonus associated with hyperthyroidism and thymoma; a case report. Chinese Med J 1993; 51: 138–140.

    CAS  Google Scholar 

  63. Panagariya A, Sharma A, Chhabria H. Hypoparathyroidism presenting as uncontrolled seizures. J Assoc Physicians India 1990; 38: 442.

    PubMed  CAS  Google Scholar 

  64. Mithal A, Menon PS, Ammini AC, Karmarkar MG, Ahuja MM. Spontaneous hypoparathyroidism: clinical, biochemical and radiologic features. Indian J Pediatr 1989; 56: 267–272.

    Article  PubMed  CAS  Google Scholar 

  65. Reddy ST, Merrick RD. Hypoparathyroidism, intracranial calcification and seizures, 61 years after thyroid surgery. Tenn Med 1999; 92: 341–342.

    PubMed  CAS  Google Scholar 

  66. Watanabe T, Bai M, Lane CR, et al. Familial hypoparathyroidism: identification of a novel gain of function mutation in transmembrane domain 5 of calcium-sensing receptor. J Clin Endocrinol Metab 1998; 83: 2497–2502.

    Article  PubMed  CAS  Google Scholar 

  67. Fulop M, Zeifer B. Case report: extensive brain calcification in hypoparathyroidism. Am J Med Sci 1991; 302: 292–295.

    Article  PubMed  CAS  Google Scholar 

  68. el Maghraoui A, Birouk N, Zaim A, Slassi I, Yahyaoui M, Chkili T. Fahr syndrome and dysparathyroidism. 3 cases. Presse Med 1995; 24: 1301–1304.

    PubMed  Google Scholar 

  69. Scire G, Dallapiccola B, Iannetti P, et al. Hypoparathyroidism as the major manifestation in two patients with 22g11 deletions. Am J Med Genet 1994; 52: 478–482.

    Article  PubMed  CAS  Google Scholar 

  70. Brisse F, Breton D, Gagey V, Cheron G. Convulsions and neonatal hypoparathyroidism revealing maternal hyperparathyroidism. Archiv Pediatr 1994; 1: 255–259.

    CAS  Google Scholar 

  71. Commentz JC, Helmke K. Precocious puberty and decreased melatonin secretion due to a hypothalamic hamartoma. Hormone Res 1995; 44: 271–275.

    Article  PubMed  CAS  Google Scholar 

  72. Machachoklertwattana P, Kaplan SL, Grumbach MM. The luteinizing hormone-releasing hormone-secreting hypothalamic hamartoma is a congenital malformation: natural history. J Clin Endocrinol Metab 1993; 77: 118–124.

    Article  Google Scholar 

  73. Valdueza JM, Cristante L, Dammann O, et al. Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery 1994; 34: 949–958.

    Article  PubMed  CAS  Google Scholar 

  74. Acilona Echevarria V, Casado Chocan JL, et al. Gelastic seizures, precocious puberty and hypothalamic hamartomas: a case report and the contributions of Single Photon Emission Computed Tomography (SPECT). Neurologia 1994; 9: 61–64 (abstract).

    Google Scholar 

  75. Minns RA, Stirling HF, Wu FC. Hypothalamic hamartoma with skeletal deformities, gelastic epilepsy, and precocious puberty. Dey Med Child Neurol 1994; 26: 173–176.

    Google Scholar 

  76. Munari C, Kahane P, Francione S, et al. Role of hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol 1995; 95: 154–160.

    Article  PubMed  CAS  Google Scholar 

  77. Kuzniecky R, Gurthrie B, Mountz J, Faught E, Gilliam F, Liu HG. Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol 1998; 43: 273–275.

    Article  Google Scholar 

  78. Tasch E, Cendes F, Li LM, et al. Hypothalmaic hamartomas and gelastic epilepsy: a spectroscopic study. Neurology 1998; 51: 1046–1050.

    Article  PubMed  CAS  Google Scholar 

  79. Arroyo S, Santamria J, Sanmari F, et al. Ictal laughter associated with paroxysmal hypothalamopituitary dysfunction. Epilepsia 1997; 38: 114–117.

    Article  PubMed  CAS  Google Scholar 

  80. Nishio S, Fujiwara S, Aiko Y, Takeshita I, Fukui M. Hypothalamic hamartoma. Report of two cases. J Neurosurg 1989; 70: 640–645.

    Article  PubMed  CAS  Google Scholar 

  81. Georgakoulias N, Vize C, Jenkins A, Singounas E. Hypothalamic hamartoma causing epilepsy: two cases and a review of the literature. Seizure 1998; 7: 167–171.

    PubMed  CAS  Google Scholar 

  82. Cascino GD, Andermann F, Berkovic SF, et al. Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology 1993; 43: 747–750.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Cormac A. O’Donovan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ramel A. Carlos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Clinical Neurological Sciences, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland

    Norman Delanty MB, FRCPI (Consultant Neurologist) (Consultant Neurologist)

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

O’Donovan, C.A., Carlos, R.A. (2002). Seizures and Endocrine Disorders. In: Delanty, N. (eds) Seizures. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-094-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-094-0_7

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-207-0

  • Online ISBN: 978-1-59259-094-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation