Collins Joel, Espinosa James, Lee James, Lucerna Alan
Emergency Medicine, Jefferson Health, Stratford, USA.
Cureus. 2025 May 16;17(5):e84222. doi: 10.7759/cureus.84222. eCollection 2025 May.
Here, we present the case of a 47-year-old male with a history of diabetes mellitus (DM), who was brought to the emergency department (ED) with right-sided hemiparesis and slurred speech. His blood sugar was 37 mg/dL. An intravenous line was established, and the patient was administered intravenous dextrose. Within five minutes, his symptoms had significantly improved and, by 15 minutes, had resolved completely. A CT head and CT angiogram of the head and neck were within normal limits. Basic laboratory tests were within normal limits. The initial neurology service consult concluded that his diagnosis was hypoglycemic hemiplegia. The patient was admitted to the hospital for evaluation of blood sugar and for an MRI brain. The patient required one more dose of dextrose two hours after arrival for a blood sugar of 60 mg/dL. The MRI brain was normal. This case illustrates that hypoglycemia can present with stroke-like symptoms. In our case, the etiology of the hypoglycemia itself was associated with missed meals and a relatively excessive medication regimen for diabetes. It is for such cases as the one presented that stroke protocols emphasize early assessment of the blood glucose level.
在此，我们介绍一例47岁男性病例，该患者有糖尿病病史，因右侧偏瘫和言语不清被送至急诊科。他的血糖为37mg/dL。建立了静脉通路，并给患者静脉输注了葡萄糖。五分钟内，他的症状明显改善，到15分钟时，症状完全消失。头部CT及头颈部CT血管造影均正常。基本实验室检查也正常。最初的神经科会诊结论是他的诊断为低血糖性偏瘫。患者因血糖评估及脑部MRI检查入院。患者到达两小时后，血糖为60mg/dL，还需要再输注一次葡萄糖。脑部MRI正常。该病例表明低血糖可表现为类似中风的症状。在我们的病例中，低血糖本身的病因与漏餐以及相对过量的糖尿病药物治疗方案有关。正是针对像本病例这样的情况，中风诊疗方案强调早期评估血糖水平。
