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Related Concept Videos

Hypoglycemia01:26

Hypoglycemia

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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...
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Hypoglycemia and Glucagon01:15

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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...
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Hepatic Encephalopathy01:29

Hepatic Encephalopathy

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DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
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Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

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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...
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Hyperglycemia01:29

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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...
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Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

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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...
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Severe hypoglycemia masquerading as cerebellar stroke.

Naman Agrawal1, Nayer Jamshed1, Praveen Aggarwal1

  • 1Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.

Journal of Family Medicine and Primary Care
|February 7, 2015
PubMed
Summary

Severe hypoglycemia can mimic a cerebellar stroke, presenting with stroke-like symptoms. Prompt treatment with dextrose resolved the symptoms, highlighting the importance of checking blood glucose in stroke patients.

Keywords:
Cerebellarhemiplegiahypoglycemiamyelinolysisstroke

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Area of Science:

  • Neurology
  • Endocrinology
  • Emergency Medicine

Background:

  • Hypoglycemia is a frequent emergency department presentation in diabetic patients.
  • Cardiovascular and neuroglycopenic symptoms of hypoglycemia are well-documented.
  • Cerebellar stroke symptoms are typically associated with neurological deficits affecting coordination and balance.

Observation:

  • A 55-year-old female presented with symptoms mimicking a cerebellar stroke.
  • Severe hypoglycemia was identified as the underlying cause.
  • Neurological deficits resolved completely following intravenous dextrose administration.

Findings:

  • This case presents a rare instance of hypoglycemia manifesting as cerebellar stroke.
  • Cerebellar signs and symptoms, including ataxia and dysmetria, were reversed with glucose.
  • Cerebral imaging and vascular studies were unremarkable, ruling out structural or vascular causes.

Implications:

  • Physicians should consider hypoglycemia in the differential diagnosis of stroke patients.
  • Early detection and management of hypoglycemia can prevent irreversible neurological damage.
  • This case underscores the diverse neurological presentations of metabolic disturbances.