Persistent hypoglycemic hemiplegia : A case report

J Korean Neurol Assoc > Volume 15(1); 1997 > Article

Journal of the Korean Neurological Association 1997;15(1): 237-240.

지속적 저혈당성 편마비 1례

김병건, 구자성, 윤창호, 김성훈, 이한보, 박성호

서울특별시립 보라매병원 신경과, 서울대학교 의대 신경과

Persistent hypoglycemic hemiplegia : A case report

Yong S. Lee. M.D., Byung K. Kim, M.D., Ja S. Koo. M.D., Chang H. Yun M.D., Sung H. Kim, M.D., Han B. Lee, M.D., and Seong H. Park, M.D.

Department of Neurology, Seoul City Boramae Hospital and College of Medicine, Seoul National University

Abstract

Hypoglycemia sometimes manifests as focal neurologic deficits simulating cerebrovascular disease. Symptoms are usually resolved by glucose infusion, but persistent hemiplegia is rarely reported. A 68-year-old diabetic woman on oral hypoglycemic agent(OHA) was admitted with right hemiplegia and global aphasia. Blood glucose level was 29 mg/dl on admission. No evidence of cerebral infarct or underlying brain disease could be found on initial brain CT and follow up MRI. Focal stenosis or occlusion was also absent on MR angiography. Hemiplegia and aphasia were not improved despite adequate therapy. Hypoglycemic hemiplegia should be suspected in all diabetic patients using insulin or OHA with stroke-like episode, and we suggest that prolonged hypoglycemia may be related to persistence of neurologic deficits.