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Which endocrine diseases are complicated by seizures?
Seizures most commonly occur after an acute change in endocrine function and usually result from electrolyte imbalance.
They occur in 50% or more of patients with hypoparathyroidism because of the hypocalcemia.
Although seizures are usually generalized, partial or absence seizures may also complicate hypoparathyroidism.
Seizures do not occur in hyperparathyroidism.
Seizures may be the presenting sign in 20% of all hypothyroid patients and are nearly always generalized. In contrast, the incidence of seizures in thyrotoxicosis is only 5% to 10%.
In Addison’s disease, seizures follow the rapid onset of serum hyponatremia (<115 mEq/L) and carry a subsequent mortality of greater than 50%.
Seizures are seen in DI only with rapid elevation of serum sodium (usually to greater than 160 mEq/L).
In DI, seizures are often partial and may occur as a result of either brain shrinkage with focal hemorrhage or during rehydration.
Seizures are observed with other endocrine causes of brain shrinkage, such as in nonketotic hyperosmolar states from DM.
In this setting, up to 25% of patients develop partial or generalized motor seizures that may evolve into epilepsia partialis continua or generalized status epilepticus.
Seizures may also be seen in DM as the result of hypoglycemia from insulin therapy but are distinctly uncommon in diabetic ketoacidosis.
Seizures are not typically associated with Cushing’s disease or acromegaly.
Sources
- Jacobs BS, Levine SR: Antiphospholipid antibody syndrome. Curr Treat Options Neurol 2:449-458, 2000.
- Valesini G, Pittoni V: Treatment of thrombosis associated with immunological risk factors. Ann Med 32(Suppl 1):41-45, 2000.
