Reactive hypoglycaemia: a rarely considered 'stroke mimic' in non-diabetic individuals

BMJ Case Rep. 2018 Jun 19:2018:bcr2017223955. doi: 10.1136/bcr-2017-223955.

Abstract

Hypoglycaemia is a well-documented 'stroke mimic'. The literature documents numerous case reports of patients presenting with focal neurological deficits subsequently attributed to hypoglycaemia. The significant majority of these cases are found in patients with pre-existing diabetes. We present case histories of two patients with no history of diabetes presenting to secondary care with reactive hypoglycaemia causing transient symptoms that were responsible for referral as a possible transient ischaemic attack. Although uncommon, metabolic disturbances such as hypoglycaemia should be considered in all patients presenting as a suspected stroke, even if they are not known to have diabetes.

Keywords: metabolic disorders; stroke.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Brain / diagnostic imaging
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Diseases / diagnosis
  • Diagnosis, Differential
  • Glucose Tolerance Test
  • Humans
  • Hypoglycemia / complications*
  • Hypoglycemia / diagnosis
  • Hypoglycemia / diet therapy
  • Ischemic Attack, Transient / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Risk Factors
  • Ultrasonography, Doppler

Substances

  • Blood Glucose