Malouf R, Brust J C
Ann Neurol. 1985 May;17(5):421-30. doi: 10.1002/ana.410170502.
During a 12-month prospective study there were 125 visits to the Harlem Hospital Emergency Room for symptomatic hypoglycemia. Sixty-five patients had obtundation, stupor, or coma; 38 had confusion or bizarre behavior; 10 were dizzy or tremulous; 9 had had seizures; and 3 had suffered sudden hemiparesis. Diabetes mellitus, alcoholism, and sepsis, alone or in combination, accounted for 90% of predisposing conditions; others included fasting, terminal cancer, gastroenteritis, insulin abuse, and myxedema. Average blood glucose levels were lower among comatose than among obtunded patients, but overlap was considerable, and overall there was little correlation among cause, blood glucose levels, and symptoms. Although mortality was 11%, only one death was attributable to hypoglycemia per se, and only four survivors had focal neurological residua.
在一项为期12个月的前瞻性研究中，有125人次因症状性低血糖前往哈莱姆医院急诊室就诊。65名患者出现意识模糊、昏迷或昏睡；38名患者有精神错乱或怪异行为；10名患者头晕或颤抖；9名患者有癫痫发作；3名患者突发偏瘫。糖尿病、酗酒和败血症单独或合并出现，占诱发因素的90%；其他因素包括禁食、晚期癌症、肠胃炎、胰岛素滥用和黏液性水肿。昏迷患者的平均血糖水平低于意识模糊患者，但重叠情况相当严重，总体而言，病因、血糖水平和症状之间几乎没有相关性。尽管死亡率为11%，但仅1例死亡可归因于低血糖本身，仅有4名幸存者有局灶性神经后遗症。
