Metabolic Disturbances And Seizures

To the Editor.— I read with interest the case of "Brain Tumor With Hyperosmolar Hyperglycemic Nonketotic Diabetic Coma," reported by Denton et al (218:256, 1971). Interpretation of the sequence of events does not appear logical in the light of what is known about this metabolic disturbance. The authors stated that "the syndrome was precipitated by a seizure related to the meningioma." We described focal seizures as a manifestation of nonketotic hyperglycemia 1 and demonstrated in an experimental model that seizure activity can be stimulated from a previously established epileptogenic focus by the administration of hypertonic glucose solutions. 2 This model is the experimental replica of the clinical situation encountered by Denton et al. It would seem more likely that the seizure the authors report resulted from the combination of a focal lesion rendered epileptogenic by the occurrence of the metabolic imbalance rather than being the cause of the latter. The