J Korean Soc Magn Reson Med.  2014 Dec;18(4):357-361. 10.13104/jksmrm.2014.18.4.357.

Rapid Regression of White Matter Changes in Hypoglycemic Encephalopathy

• Son SW
• Lee KH
• Yoo DS

• KMID: 2206933
• DOI: http://doi.org/10.13104/jksmrm.2014.18.4.357

Abstract

PURPOSE
In a previous report, it took several days for white matter lesions to regress in hypoglycemic encephalopathy. We present a case of rapid diffusion-weighted image (DWI) changes in hypoglycemic encephalopathy.
CASE REPORT
A 58-year-old male patient was found semi-comatous with the only abnormality in his laboratory tests showing hypoglycemia (44 mg/dL). After rapid correction of glucose level, immediate brain DWI showed bilateral subcortical white matter lesions. After about 5 hours, follow-up DWI showed resolved subcortical white matter lesions, with newly-appeared bilateral fronto-temporo-parietal cortical lesions.
CONCLUSION
Both white matter and cortex involvement in hypoglycemic encephalopathy has been shown in several reports, but rapid regression of white matter changes in hypoglycemic encephalopathy has been rarely reported. It is important to know that MR imaging changes in hypoglycemic encephalopathy can be made as quick as just a few-hour-long.

Keyword

Hypoglycemic encephalopathy; Diffusion-weighted image; White matter

MeSH Terms

Brain
Follow-Up Studies
Glucose
Humans
Hypoglycemia
Magnetic Resonance Imaging
Male
Middle Aged
Glucose