Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine Keio University, School of Medicine, Shinjuku, Japan.
Ups J Med Sci. 2012 Aug;117(3):347-51. doi: 10.3109/03009734.2011.652748. Epub 2012 Jan 17.
An 89-year-old man with diabetes treated with metformin 500 mg/day and glimepiride 4 mg/day was hospitalized because of hypoglycemic right hemiparesis and dysarthria (casual glucose value 1.8 mmol/L), which resolved quickly following administration of 40 mL of 40% dextrose. Hemiparesis is a rare symptom (4.2%) of hypoglycemia. There are about 200 case reports of hypoglycemic hemiparesis. The average glucose level at which hemiparesis developed was 1.8 mmol/L. Right-sided hemiparesis predominated (R 66%; L 34%). On imaging studies, abnormal findings were frequently observed in the internal capsule or splenium of the corpus callosum. The mechanism of hemiparesis is not fully understood. The existence of cases in which hypoglycemia cannot be distinguished from stroke on imaging studies suggests the importance of measurement of the blood glucose level when the symptoms of stroke are first recognized.
一位 89 岁的男性糖尿病患者，每天服用二甲双胍 500mg 和格列美脲 4mg，因低血糖性右侧偏瘫和构音障碍（随机血糖值 1.8mmol/L）住院，经给予 40ml40%葡萄糖后迅速缓解。偏瘫是低血糖的罕见症状（4.2%）。约有 200 例低血糖性偏瘫的病例报告。偏瘫发生时的平均血糖水平为 1.8mmol/L。右侧偏瘫为主（R 66%；L 34%）。在影像学研究中，经常观察到内囊或胼胝体压部的异常表现。偏瘫的机制尚不完全清楚。在影像学研究中，有些病例低血糖与中风无法区分，这表明在首次出现中风症状时测量血糖水平非常重要。
