Paralysis in an adolescent

An 18-year-old male with a history of diabetes presented with hemiparesis. His serum glucose was low, but did not fit the numerical criteria for hypoglycemia. His symptoms rapidly reversed after glucose infusion. This case illustrates crucial features of hypoglycemia. Symptoms may be atypical in the young adult population and may occur at levels higher than numerical definitions. Clinicians should be vigilant regarding the variability in symptoms of hypoglycemia and serum levels necessary to produce them. Lack of vigilance can lead to delayed critical intervention. Understanding this aspect of hypoglycemia also has implications for training prehospital personnel.