Rodriguez-Hernandez Adrian, Babici Denis, Campbell Maryellen, Carranza-Reneteria Octavio, Hammond Thomas
Department of Neurology, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States.
eNeurologicalSci. 2023 Jan 17;30:100444. doi: 10.1016/j.ensci.2023.100444. eCollection 2023 Mar.
Acute hypoglycemia may mimic acute ischemic stroke, but to our knowledge this has never been reported as transient hemineglect syndrome. We present a 60-year-old male with known diabetes mellitus who was brought to the hospital as a stroke alert. The patient had undetectable glucose levels upon arrival of emergency medical services (EMS), therefore hypertonic glucose was given. On our assessment in the emergency department (ED)he turned his head to the right side, looking to the right to answer questions when addressed on his left side. The extinction and neglect assessment revealed left-sided extinction on double tactile and visual stimulation. CT perfusion of the brain showed a decreased perfusion in the right cortical area. Given the unclear last known normal, urgent brain magnetic resonance imaging (MRI) was performed; stroke was excluded. The patient was admitted to the Intensive Care Unit where glucose was closely monitored. Electroencephalogram showed absence of seizure or postictal activity. The following morning, the patient returned to baseline and was able to recall the event. The episode was attributed to the severe hypoglycemia because of a recent medication change.
急性低血糖可能会模仿急性缺血性中风，但据我们所知，从未有过将其报告为短暂性偏侧忽视综合征的情况。我们报告一名60岁患有糖尿病的男性，他因中风警报被送往医院。急救医疗服务（EMS）到达时，患者血糖水平检测不到，因此给予了高渗葡萄糖。在急诊科（ED）评估时，当在其左侧与他交谈时，他将头转向右侧，看向右侧以回答问题。双侧触觉和视觉刺激的消退和忽视评估显示左侧消退。脑部CT灌注显示右侧皮质区域灌注减少。鉴于最后已知正常状态不明，进行了紧急脑部磁共振成像（MRI）检查；排除了中风。患者被收入重症监护病房，在那里密切监测血糖。脑电图显示无癫痫发作或发作后活动。第二天早上，患者恢复到基线状态，并且能够回忆起该事件。该发作归因于近期药物变化导致的严重低血糖。
