known diabetic female presented with severe symptoms of prolonged neglected hypoglycemia as altered mental status, seizures and finally coma. The cause mainly owing to an overdose of hypoglycemic medication. Consequent occurrence of the radiological image of hypoglycemic encephalopathy in MRI examination.

Differential diagnoses are:

• hypoxic-ischemic brain injury: may show symmetrical thalamic lesions

• Creutzfeldt-Jakob disease (CJD): different clinical presentation

• ischemic infarct: usually focal and unilateral

• seizure-related changes