title: [Diagnostic pitfalls in sulfonylurea-induced neuroglycopenic syndrome with hemiparesis, dysphasia and somnolence].
abstract: BACKGROUND
  The neuroglycopenic syndrome, which is often due to sulfonylurea-induced hypoglycemia, is frequently overlooked or misinterpretated as cerebral ischemia.
  
  
  METHODS
  Two women aged 81 and 83 years, respectively, with type II diabetes treated with sulfonylureas presented with hemiparesis, dysphasia and somnolence. Both, general practitioner and emergency room physician first interpretated the symptoms as clinical signs of stroke without determination of blood glucose. After hours of delay due to unnecessary and expensive examinations including cerebral computed tomography the correct diagnosis of hypoglycemia was finally made. After injection of i.v. glucose the symptomatology was completely reversible.
  
  
  CONCLUSIONS
  In every case of disturbance of consciousness, acute neurologic deficits and psychiatric abnormalities an immediate blood glucose test should be performed to exclude hypoglycemia.
authors.affiliation: Medizinische Klinik, Klinikums Lippe-Detmold.
authors.forename: A
authors.initials: A
authors.lastname: Holstein
authors.forename: H G
authors.initials: HG
authors.lastname: Lankes
authors.forename: E H
authors.initials: EH
authors.lastname: Egberts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000139:chemically induced*; D002544:Cerebral Infarction / Q000175:diagnosis*; D003244:Consciousness Disorders / Q000139:chemically induced*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D005905:Glyburide / Q000008:administration & dosage / Q000009:adverse effects*; D006429:Hemiplegia / Q000139:chemically induced*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000175:diagnosis; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D012646:Self Administration
chemical_list: D007004:Hypoglycemic Agents; D005905:Glyburide
vernacular_title: Diagnostischer Irrweg bei sulfonylharnstoffinduzierten neuroglukopenischen Syndromen mit Hemiparese, Dysphasie und Somnolenz.