title: Diffusion-weighted MRI predicts prognosis in severe hypoglycemic encephalopathy.
abstract: A 20-year-old woman presented unconscious due to hypoglycemia after a self-administered insulin injection. Diffusion-weighted MRI (DWI), performed 5 days after admission, demonstrated heterogeneous high-intensity signal areas in both the cortex and subcortex but sparing the motor and sensory centers. On the 11th day after admission, she began making incomprehensible verbal sounds, eye opening spontaneously and moving her extremities with pyramidal tract signs. Three months later, she had aphasia, agnosia and apraxia but a normal gait without pyramidal tract signs or ataxia. DWI is thus considered useful to predict the functional outcome of patients with severe hypoglycemia.
authors.affiliation: Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-1 Tokorozawa, Saitama 359-8513, Japan. yanagawa@me.ndmc.ac.jp
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yanagawa
authors.forename: Naoaki
authors.initials: N
authors.lastname: Isoi
authors.forename: Aya M
authors.initials: AM
authors.lastname: Tokumaru
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000150:complications*; D007328:Insulin / Q000008:administration & dosage; D020258:Neurotoxicity Syndromes / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012646:Self Administration
chemical_list: D007328:Insulin