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Transient hypoglycemic paraparetic syndrome in an elderly patient
Journal of the National Medical Association
|April 1, 1987
Summary
An elderly diabetic patient experienced temporary leg weakness due to low blood sugar from glyburide. This case highlights the risks of tight glucose control in older adults, emphasizing careful medication management.
Area of Science:
- Neurology
- Endocrinology
- Geriatrics
Background:
- Elderly diabetic patients are susceptible to hypoglycemia.
- Inappropriate medication management can lead to adverse events.
Observation:
- A transient hypoglycemic paraparetic episode occurred in an elderly diabetic patient.
- The episode was linked to glyburide administration without other predisposing factors.
- Clinical signs included paraparesis, more pronounced on the right side.
Findings:
- Paraparesis resolved within two hours after intravenous glucose administration.
- The underlying mechanism involved loss of cerebrovascular autoregulation in the vertebral-basilar artery distribution.
- Hypoglycemia can precipitate neurological deficits in vulnerable elderly patients.
Implications:
- Management of paraparetic syndromes requires thorough assessment of predisposing factors.
- Avoidance of overly strict glycemic control in the elderly is crucial to prevent hypoglycemia and potential brain injury.
- This case underscores the importance of individualized diabetes management in older adults.
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