Brain Neurorehabil.  2015 Sep;8(2):113-116. 10.12786/bn.2015.8.2.113.

Progress of Rehabilitation in Patients with Hypoglycemic Encephalopathy Accompanying Dysphagia and Voiding Difficulty: A Case Report

• Jo H
• Park HW
• Baek S

• KMID: 2165200
• DOI: http://doi.org/10.12786/bn.2015.8.2.113

Abstract

Dysphagia and voiding difficulty after hypoglycemic encephalopathy (HE) are not well described in the literature. Additionally, the effect of rehabilitation on outcomes of HE has not been discussed enough. Here we report two cases of HE, who underwent comprehensive rehabilitative management. A 76-year-old man with HE had cognitive dysfunction, dysphagia, poor standing balance, and voiding difficulty. After rehabilitation for about 20 days, the patient's swallowing, gait, and voiding function was improved remarkably, and he could eat a tolerable diet, walk independently, and void without catheterization. However, the cognitive function changed a little. A 75-year-old woman with HE had cognitive dysfunction, impaired gait, dysphagia, and voiding difficulty. After rehabilitation for one month, the patient made progress in swallowing and gait. However, the cognitive function changed a little. After rehabilitation, the recovery of swallowing and locomotor function was rapid and satisfactory in two cases, however, the progress of cognitive function was not definite.

Keyword

hypoglycemic encephalopathy; dysphagia; rehabilitation

MeSH Terms

Aged
Catheterization
Catheters
Deglutition
Deglutition Disorders*
Diet
Female
Gait
Humans
Rehabilitation*

Figure

• 

  Fig. 1 Axial diffusion-weighted magnetic resonance images (A) and axial apparent diffusion coefficient maps (B) obtained 1 day after hypoglycemic attack showing small chronic ischemic lesions in the basal ganglia and deep white matter of both the hemispheres, without signs of acute lesions. An initial VFSS showing subglottic aspiration of thin fluid (C), and a follow-up VFSS showing no signs of aspiration (D). Initial standing balance is poor and gait with a walker requires minimal assistance from a physical therapist (E). After 20 days of rehabilitation, the patient is walking independently (F). VFSS: Videofluoroscopic swallowing study.

• 

  Fig. 2 Axial diffusion-weighted magnetic resonance images (A) and axial apparent diffusion coefficient maps (B) obtained 1 day after hypoglycemic attack showing multiple microbleeds in both the basal ganglia and right cerebral subcortical white matter. An initial VFSS showing subglottic aspiration of thin fluid (C), and a follow-up VFSS showing no signs of aspiration (D). Initial standing balance is poor and the patient is unable to ambulate (E). After 1 month of rehabilitation, the patient is walking with minimal assistance (F). VFSS: Videofluoroscopic swallowing study.

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