Cortical excitability changes correlate with fluctuations in glucose levels in patients with epilepsy

Abstract

We used transcranial magnetic stimulation (TMS) to investigate motor cortical excitability changes in relation to blood glucose levels. Methods: Twenty-two drug-naïve patients with epilepsy [11 generalized and 11 focal] and 10 controls were studied twice on the same day; first after 12. h of fasting and then 2. h postprandial. Motor threshold and paired-pulse TMS at a number of short and long interstimulus intervals were measured. Serum glucose levels were measured each time. Results: Decreased long intracortical inhibition was seen in patients and controls during fasting compared to postprandial studies. This effect was much more prominent in patients with generalized epilepsy (with effect ..