["Locked-in" syndrome due to hyperglycemia]

Area of Science:

• Neurology
• Endocrinology

Background:

• Hypoglycemia can induce diffuse brain dysfunction.
• It may present as focal neurological deficits, mimicking cerebrovascular events.

Observation:

• A 67-year-old male with type 2 diabetes on glibenclamide presented with acute right-sided weakness and speech difficulty.
• Neurological examination revealed complete quadriplegia and bilateral Babinski signs.

Findings:

• Blood glucose was critically low at 24 mg/dl.
• Intravenous glucose administration resulted in rapid and complete neurological recovery.

Implications:

• Highlights the critical need to measure blood glucose in acute neurological dysfunction.
• Underscores hypoglycemia as a potential mimic of stroke, necessitating differential diagnosis.