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Hypoglycaemic hemiplegia: a repeat SPECT study

S Shintani1, S Tsuruoka, T Shiigai

  • 1Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.

Journal of Neurology, Neurosurgery, and Psychiatry
|June 1, 1993
PubMed
Summary
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Severe hypoglycemia caused temporary right-sided paralysis. Brain scans showed reduced blood flow in the left hemisphere, indicating its vulnerability during critical conditions like hypoglycemia.

Area of Science:

  • Neurology
  • Nuclear Medicine

Background:

  • Hypoglycemia, particularly from oral hypoglycemic agents, can lead to neurological deficits.
  • Right hemiplegia is a rare but serious complication of severe hypoglycemia.

Observation:

  • A patient presenting with right hemiplegia following an intentional overdose of oral hypoglycemic agents showed normal brain CT and angiography.
  • Single-photon emission computed tomography (SPECT) scans performed one and six days post-event revealed relative hypoperfusion in the left cerebral hemisphere.

Findings:

  • Repeat SPECT studies indicated that the left cerebral hemisphere exhibited greater vulnerability in terms of cerebral blood perfusion compared to the right hemisphere.
  • This hemispheric vulnerability may precipitate neurological deficits, such as hemiplegia, under critical conditions like severe hypoglycemia.

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Implications:

  • The findings suggest a potential mechanism for hypoglycemia-induced hemiplegia related to regional cerebral blood flow vulnerability.
  • This highlights the importance of assessing cerebral perfusion in patients with neurological deficits secondary to metabolic disturbances.
  • Further research into hemispheric vulnerability in metabolic encephalopathies could inform clinical management strategies.