Lateralization of hypoglycemic encephalopathy: evidence of a mechanism of selective vulnerability.
BACKGROUND
One of the characteristics of hypoglycemic encephalopathy (HE) is selective vulnerability of different brain regions.


METHODS
We observed a patient with unilateral HE affecting the right internal capsule and the subcortical white matter. The patient had a preexisting stroke in the opposite hemisphere. The hemisphere that was affected by HE exhibited greater regional blood flow (single positron-emission tomography) and higher fractional anisotropy (diffusion-tensor imaging) than the unaffected hemisphere.


CONCLUSIONS
This case suggests that the degree of metabolism required to maintain the function of brain structures and neuronal integrity is an important factor determining the selective vulnerability in HE.
Lee
Seung-Hwan
SH
Department of Neurology, Kangwon National University College of Medicine, Chuncheon, Korea.
Kang
Chang Don
CD
Kim
Sam Soo
SS
Tae
Woo-Suk
WS
Lee
Seo-Young
SY
Kim
Sung Hun
SH
Koh
Sung Hye
SH