Encephalopathies and other toxic-metabolic conditions Hyperglycemia with hyperosmolar state may be associated with focal neurologic deficits simulating stroke but focal seizures are reported in this condition as well. Focal neurologic signs with hyperglycemia may include aphasia, homonymous hemianopia, hemisensory deficits, hemiparesis, unilateral hyperreflexia, and the presence of a Babinski sign.17 Other metabolic encephalopathies reported to cause strokelike conditions include hyponatremia and hepatic encephalopathy