Focal Seizures Induced by Non Ketotic Hyperglycemia in A Known Case of Type 2 Diabetes Mellitus

Background: Focal seizures are a notable complication in patients with poorlycontrolled diabetes, particularly in the context of non-ketotichyperglycemia (NKH).Seizures associated with NKH are refractory to conventional antiepileptic drugs(AEDs) but respond effectively to glycemic control. This study evaluates the efficacyof insulin and rehydration over AEDs in managing NKH-induced seizures, highlightingthe importance of early blood glucose monitoring in seizure presentations. Methods: Asingle-case observational study was conducted on a 58-year-old female with type 2diabetes mellitus presenting with focal seizures. Diagnostic evaluations included bloodglucose levels, serum osmolality, and imaging studies. The patient received both AEDsand insulin-based therapy, and seizure outcomes were monitored. Results: Despitemaximum doses of phenytoin, seizures persisted until blood glucose levels werenormalized through insulin therapy and hydration. The patient’s seizures resolvedcompletely following glycemic correction, allowing successful withdrawal of AEDs.Conclusion: Insulin and hydration are more effective than AEDs in managing NKHinduced focal seizures. Early recognition of hyperglycemia and appropriate glycemicmanagement can prevent unnecessary AED use and improve outcomes.