Hypoglycemic hemiplegia: two cases and a clinical review

Area of Science:

• Neurology
• Endocrinology

Background:

• Cerebrovascular disease and transient ischemic attacks (TIAs) are common neurological emergencies.
• Hypoglycemia, or low blood sugar, can present with diverse neurological symptoms.

Observation:

• Two patients experienced recurrent episodes of transient hemiplegia.
• These episodes were initially misdiagnosed as TIAs.

Findings:

• Both patients had documented hypoglycemia as the cause of their hemiplegic episodes.
• Cerebral angiography revealed no evidence of cerebrovascular disease in either patient.
• Hemiplegia resolved upon reduction of insulin dosage, confirming the hypoglycemic etiology.

Implications:

• Hypoglycemic hemiplegia should be considered in the differential diagnosis of transient hemiplegia.
• Early recognition can avert extensive and potentially unnecessary cerebrovascular investigations.
• This highlights the importance of blood glucose monitoring in patients with neurological deficits.