FURTHER STUDIES ON ELECTROCEREBRAL DYSFUNCTION AND THE USE OF ANTICONVULSANTS IN LABILE DIABETES

Abstract

Of 15 labile diabetics with no family history of epilepsy, only 2 had convulsions prior to onset of diabetes. Abnormal eeg. tracings were present in 80% and patterns consistent with convulsive tendency or focal pathology in almost 50% of patients. A genetic or constitutional factor responsible for these abnormalities was considered in 3, atypical epilepsy in 1 and disturbed brain function from repeated severe insulin reactions in 8. The electrocerebral dysfunction reduced the threshold for insulin reactions, increased their frequency, lowered their response to carbohydrate therapy, and produced pseudohypoglycemic reactions. Anticonvulsants were used successfully in 6 patients, and had no effect in 1 with preexisting personality disorders. In 2 the improvement was maintained for up to 4 yrs. after discontinuation of therapy. Aggravation in the eeg. occurred in 1 who abandoned treatment. It is concluded that abnormal brain potentials are not the only cause of lability in diabetes, and if present do not always indicate irreversible brain damage. The usefulness of anticonvulsive therapy in diabetics with eeg. abnormalities is confirmed.