Hypoglycemic encephalopathy

Case contributed by Yves Leonard Voss
Diagnosis almost certain

Presentation

Patient found in coma, clinically suspected urosepsis, fever. Known alcoholism.

Patient Data

Age: 55 years
Gender: Male
mri

Symmetrical T2 / FLAIR hyperintensities and restricted diffusion of the caudate and lentiform nucleus (putamen).

Cortical restricted diffusion of the parietal, occipital and posterior temporal lobes bilaterally.

Case Discussion

The patient was found lying in bed his comatous. Known alcoholism. Body temperature 39,5°C, first diagnostic hypothesis was urosepsis. First blood glucose upon presentation in hospital 40 mg/dl.

The MRI was performed 5 days after presentation to evaluate a persistent vegetative state. This state did not improve within the 6 weeks of which we have clinical follow-up.

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