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Hypoglycemia: causes, neurological manifestations, and outcome
Annals of Neurology
|May 1, 1985
Summary
Symptomatic hypoglycemia presents with diverse neurological symptoms, often linked to diabetes, alcoholism, or sepsis. Despite severe presentations, hypoglycemia itself rarely causes death or lasting neurological damage.
Area of Science:
- Internal Medicine
- Neurology
- Endocrinology
Background:
- Hypoglycemia, or low blood glucose, can manifest with a wide range of symptoms.
- Understanding the clinical spectrum and predisposing factors is crucial for emergency room management.
Observation:
- A 12-month prospective study recorded 125 emergency room visits for symptomatic hypoglycemia.
- Observed symptoms included obtundation, stupor, coma, confusion, seizures, and hemiparesis.
- Diabetes mellitus, alcoholism, and sepsis were the most common predisposing conditions.
Findings:
- Neurological deficits varied, with lower blood glucose levels in comatose patients, but significant overlap existed.
- There was a weak correlation between the cause of hypoglycemia, blood glucose levels, and presenting symptoms.
- Mortality was 11%, but only one death was directly attributed to hypoglycemia itself.
Implications:
- Symptomatic hypoglycemia requires prompt evaluation in the emergency setting.
- While hypoglycemia can cause severe neurological symptoms, it is infrequently the direct cause of mortality or permanent neurological deficits.
- Identifying underlying conditions like diabetes, alcoholism, and sepsis is key to effective treatment and prevention.
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