Hypoglycemic Hemiplegia Associated with Reversible Narrowing of the Contralateral Middle Cerebral Artery in a Patient with Adrenal Insufficiency
Open accessAbstract
A 56-year-old man with a 2.5-month history of anorexia developed sweating, weakness, and left hemiplegia and hemispatial neglect. Brain magnetic resonance imaging detected no abnormalities, but magnetic resonance angiography revealed narrowing of the right middle cerebral artery (MCA). The focal neurological signs and narrowing of the MCA resolved after detection and correction of hypoglycemia. Endocrinological examinations indicated adrenal insufficiency. Hemiplegia is a rare but important neurological manifestation of hypoglycemia, although the mechanisms involved remain unknown. Combined hypoglycemia and decreased MCA blood flow associated with vasospasm probably induced regionally severe neuroglycopenia with ischemia, which presented as focal neurological symptoms.
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Genuine endocrine diseases, like pituitary or adrenal insufficiency, should also be considered especially if patients present with other symptoms suggestive of these diseases.
“Genuine endocrine diseases, like pituitary or adrenal insufficiency, should also be considered especially if patients present with other symptoms suggestive of these diseases [11,12].”
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“Genuine endocrine diseases, like pituitary or adrenal insufficiency, should also be considered especially if patients present with other symptoms suggestive of these diseases [11,12].”
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Liu, J., Lv, D., Li, S., An, Z., He, Z., & Liu, Y. (2024) · Brain and Behavior · doi:10.1002/brb3.70186
- Authors
- Sakurai, Y., Ohara, N., Fukai, Y., Seki, Y., Akiyama, K., Yoneoka, Y., Takada, T., Tani, T., Terajima, K., Ozawa, T., & Sone, H.
- Affiliations
- Uonuma kikan Hospital (JP)
- Niigata University (JP)
- ORCID
- Venue
- Internal Medicine
- Published
- 2023-03-01
- Volume
- 62
- Issue
- 5
- Pages
- 751-756
- ISSN
- 0918-2918 (ISSN-L)
- 1349-7235
- PMC
- PMC10037026
- OpenAlex
- W4286384834
- Cited by
- 3
- References
- 21
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Internal Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hypoglycemia, hemiplegia, middle cerebral artery stenosis, adrenal insufficiency, neuroglycopenia, cerebral vasospasm, hemispatial neglect, anorexia
- MeSH terms
- Adrenal Insufficiency, Hemiplegia, Humans, Hypoglycemia, Hypoglycemic Agents, Male, Middle Aged, Middle Cerebral Artery
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