Related Experiment Video
Updated: Jul 11, 2026
09:35
A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
Published on: November 15, 2024
Hypoglycemic hemiplegia: insulinoma masquerading as stroke.
V Shanmugam1, S Zimnowodzki, J Curtin
1Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA.
Summary
Recurrent hemiplegia episodes were linked to hypoglycemia caused by an insulinoma. Surgical removal of the tumor normalized blood glucose, resolving symptoms and highlighting the link between low blood sugar and neurological deficits.
Area of Science:
- Neuroscience
- Endocrinology
- Metabolic Disorders
Background:
- Hypoglycemia, or low blood glucose, can manifest with diverse neurological symptoms.
- Recurrent focal neurological deficits are uncommon presentations of hypoglycemia.
- Insulinoma, a rare pancreatic tumor, is a potential cause of severe hypoglycemia.
Purpose of the Study:
- To report a case of recurrent hemiplegia secondary to hypoglycemia.
- To identify the underlying cause of hypoglycemia through diagnostic investigations.
- To discuss the pathophysiological mechanisms linking hypoglycemia to focal neurological deficits.
Main Methods:
- Clinical case presentation.
- Diagnostic workup including biochemical tests to assess blood glucose levels.
- Surgical intervention for tumor removal.
Main Results:
- The patient experienced recurrent episodes of hemiplegia attributed to severe hypoglycemia.
- Investigations confirmed the presence of an insulinoma.
- Surgical resection of the insulinoma led to normalized blood glucose levels and resolution of hemiplegic episodes.
- The patient remained asymptomatic for a 9-month follow-up period.
Conclusions:
- Insulinoma is a treatable cause of recurrent hypoglycemia-induced neurological deficits.
- This case underscores the importance of considering metabolic disturbances in the differential diagnosis of neurological symptoms.
- Understanding the pathophysiology of hypoglycemia-induced neurological deficits is crucial for effective management.
Related Concept Videos
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:21Hyperosmolar Hyperglycemic State
Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...