P.021 Hyperglycemia presenting with visual hallucinations due to occipital lobe seizures
Bibliographic record
Abstract
Background: Hyperosmotic hyperglycemic nonketotic state (HHS) is associated with myriad neurological complications such as seizures. Methods: We report a case presenting with visual hallucinations due to occipital lobe epilepsy. Results: A 67-year old woman with chronic hypertension, hyperlipidemia and diabetes mellitus non-compliant to medication presented with a 10-day history of recurrent visual phenomena in the left visual field. She described stationery multi-coloured flashing lights which decreased in intensity, brightness and size after 3 minutes. She was alert and conscious during attacks. There was no limb jerking. Neurological examination was normal with no visual field defect. Capillary glucose was 28.1 mmol/L, Hba1c 9% and B-hydroxybutyrate < 0.1. She was treated with actrapid 8 units, glipizide 5 mg BD and empagliflozin 12.5 mg OM. Interictal electroencephalogram was normal with no epileptiform activity. Brain magnetic resonance imaging revealed restricted diffusion in the right occipital cortex with corresponding cortical thickening and increased FLAIR signal with subtle hypodensity on GRE sequence. Her visual symptoms improved dramatically with hydration and diabetic control. She was treated with a short course of keppra. Conclusions: Visual hallucinations are an uncommon but well recognised and fully reversible complication of HHS. Clinicians should not forget HHS in the workup of occipital lobe epilepsy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".