Prolonged Cerebellar Ataxia: An Unusual Complication of Hypoglycemia
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
A 51-year-old male with a history of insulin-dependent diabetes and polysubstance abuse presented after overdose on insulin. Soon after resuscitation, he displayed a severe ataxia in all 4 limbs and was unable to walk; all of which persisted for at least 5 days. Laboratory testing was unrevealing, including relatively normal brain magnetic resonance imaging. He had recovered full neurologic function 3 months after the event. This report describes a case of reversible cerebellar ataxia as a rare complication of severe hypoglycemia that may occur in patients with abnormal cerebellar glucose metabolism. Thus, this phenomenon should be included in the differential diagnosis of patients with a history of hypoglycemia who present with ataxia. In this context, the differential diagnosis of cerebellar ataxia is discussed, as is the proposed mechanism for hypoglycemia-induced cerebellar dysfunction.
- Rajbhandari SM, Powell T, Davies-Jones GAB, Ward JD. Central pontine myelinolysis and ataxia: an unusual manifestation of hypoglycaemia. Diabet Med. 1998;15:259–61. CrossRef
- Schwaninger M, Haehnel S, Hess K, Fohr B, Nawroth P, Hacke W. Cerebellar ataxia after repeated hypoglycemia. Eur J Neurol. 2002;9:544–5. CrossRef
- Kim DE, Park SH, Kim SK, et al. Hypoglycemia-induced cerebellar dysfunction and quantitative positron emission tomography study. Neurology. 2000;55(3):418–22.
- Ropper AL, Brown RH, eds. Adams and Victor’s Principles of Neurology, 8th Edition. McGraw-Hill’ Access Medicine Web site; 2005. http://www.accessmedicine.com. Accessed August 10, 2007.
- Antunez E, Estruch R, Cardenal C, et al. Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy. AJR. Am J Roentgenol. 1998 Oct 171(4):1131–7.
- Kasper DL, Braunwald E, eds. Harrison’s Principles of Internal Medicine, 16th Edition. McGraw-Hill’ s Access Medicine Web site; 2005. http://www.accessmedicine.com. Accessed May 22, 2007.
- Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict. 1989 Nov; 84(11):1353–7. CrossRef
- LaManna JC, Harik SI. Regional comparisons of brain glucose influx. Brain Res. 1985;326(2):299–305. CrossRef
- Cranston I, Marsden P, Matyka K, et al. Regional differences in cerebral blood flow and glucose utilization in diabetic man: the effect of insulin. J Cereb Blood Flow Metab. 1998;18(2):130–40. CrossRef
- Prolonged Cerebellar Ataxia: An Unusual Complication of Hypoglycemia
Journal of General Internal Medicine
Volume 23, Issue 1 , pp 103-105
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- KEY WORDS
- diabetes mellitus
- Industry Sectors