Hypoglycemic hemineglect a stroke mimic

Q3 Neuroscience

eNeurologicalSci Pub Date : 2023-03-01 DOI:10.1016/j.ensci.2023.100444

Adrian Rodriguez-Hernandez, Denis Babici, Maryellen Campbell, Octavio Carranza-Reneteria, Thomas Hammond

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引用次数: 1

Abstract

Acute hypoglycemia may mimic acute ischemic stroke, but to our knowledge this has never been reported as transient hemineglect syndrome. We present a 60-year-old male with known diabetes mellitus who was brought to the hospital as a stroke alert. The patient had undetectable glucose levels upon arrival of emergency medical services (EMS), therefore hypertonic glucose was given. On our assessment in the emergency department (ED)he turned his head to the right side, looking to the right to answer questions when addressed on his left side. The extinction and neglect assessment revealed left-sided extinction on double tactile and visual stimulation. CT perfusion of the brain showed a decreased perfusion in the right cortical area. Given the unclear last known normal, urgent brain magnetic resonance imaging (MRI) was performed; stroke was excluded. The patient was admitted to the Intensive Care Unit where glucose was closely monitored. Electroencephalogram showed absence of seizure or postictal activity. The following morning, the patient returned to baseline and was able to recall the event. The episode was attributed to the severe hypoglycemia because of a recent medication change.

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低血糖半忽略卒中模拟

急性低血糖可能与急性缺血性中风相似，但据我们所知，这从未被报道为一过性半忽视综合征。我们报告一位60岁男性糖尿病患者作为中风警报被送到医院。在紧急医疗服务(EMS)到达时，患者无法检测到血糖水平，因此给予高渗糖治疗。我们在急诊科(ED)对他进行评估时，他把头转向右侧，在回答问题时看向右侧。对触觉和视觉双重刺激的消退和忽视评价显示左侧消退。脑CT灌注显示右侧皮质区灌注减少。鉴于最后已知的不明确的正常，紧急进行脑磁共振成像(MRI);排除中风。患者被送进重症监护室，在那里密切监测血糖。脑电图显示无癫痫发作或阳性活动。第二天早上，患者回到基线，并能够回忆起事件。这一事件是由于最近的药物变化引起的严重低血糖。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

期刊介绍： eNeurologicalSci provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. eNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). eNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism. The fields covered may include neuroanatomy, neurochemistry, neuroendocrinology, neuroepidemiology, neurogenetics, neuroimmunology, neuroophthalmology, neuropathology, neuropharmacology, neurophysiology, neuropsychology, neuroradiology, neurosurgery, neurooncology, neurotoxicology, restorative neurology, and tropical neurology.