Hypoglycemia can be confused with many conditions, one of which is an acute cerebrovascular accident (CVA).


Clinical features of the hemiplegia hypoglycemia syndrome:

(1) The patient presents with the acute onset of hemiplegia.

(2) The patient is found to be severely hypoglycemic.

(3) The patient may have a reduced level of consciousness or coma.

(4) There may be a history of recent insulin administration.


This may first be recognized if the initial CNS imaging studies do not show sign of a cerebrovascular accident in the region expected for the neurologic deficit.


Differential diagnosis:

(1) concurrent hypoglycemia and CVA

(2) stroke (if hypoglycemia not detected)


If the hypoglycemia is recognized early, then correction of the hypoglycemia will correct the neurological deficit. If glucose administration is delayed then the neurologic damage may be permanent.


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