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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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; both teacher heads agree on what is shown here.
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".