[Diagnostic pitfalls in sulfonylurea-induced neuroglycopenic syndrome with hemiparesis, dysphasia and somnolence].
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.
Holstein
A
A
Medizinische Klinik, Klinikums Lippe-Detmold.
Lankes
H G
HG
Egberts
E H
EH
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
D007004:Hypoglycemic Agents; D005905:Glyburide
Diagnostischer Irrweg bei sulfonylharnstoffinduzierten neuroglukopenischen Syndromen mit Hemiparese, Dysphasie und Somnolenz.