Reactive hypoglycaemia: a rarely considered 'stroke mimic' in non-diabetic individuals

Hypoglycaemia is a well-documented 'stroke mimic'. The literature documents numerous case reports of patients presenting with focal neurological deficits subsequently attributed to hypoglycaemia. The significant majority of these cases are found in patients with pre-existing diabetes. We present case histories of two patients with no history of diabetes presenting to secondary care with reactive hypoglycaemia causing transient symptoms that were responsible for referral as a possible transient ischaemic attack. Although uncommon, metabolic disturbances such as hypoglycaemia should be considered in all patients presenting as a suspected stroke, even if they are not known to have diabetes.