Independent and symmetric seizures from parasagittal cortex: is this a feature of profound hypoglycemia?

Two patients presented with severe hypoglycemia and parasagittal homotopic cerebral hemisphere injury. Days after the initial insult, bilateral, independent, periodic lateralized epileptiform discharges and frequent seizures emerged from the affected homotopic cerebral cortices in both patients. We speculate that synaptic rescaling and increased spontaneous discharges in isolated cerebral cortex may cause epileptogenesis in severe hypoglycemia. Bilateral but temporally independent parasagittal seizures could be a feature of severe hypoglycemia.