title: Hypoglycemia-induced spontaneous unilateral jerking movement in bilateral internal capsule posterior limb abnormalities.
abstract: We report an 89-year-old woman who developed consciousness disturbance associated with marked hypoglycemia, and showed involuntary movements manifested as spontaneous quick-jerking flexion followed by slow relaxation, in the right leg. Diffusion-weighted imaging revealed bilateral hyperintensities in the posterior limbs of the internal capsule (P-IC). She was treated with intravenous glucose supplementation, and her symptoms dramatically improved. The P-IC lesions are common abnormalities on MRI in hypoglycemia, and may cause paralysis. However involuntary movements associated with the lesions are rarely observed. The spontaneous jerking movements observed in this patient might result from transient impairment of the pyramidal tract associated with hypoglycemia.
authors.affiliation: Department of Neurology, Kitamurayama Public Hospital, Japan. Electronic address: s7066@nms.ac.jp.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Nakajima
authors.affiliation: Department of Neurology, Nippon Medical School, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Neurology, Nippon Medical School, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagayama
authors.affiliation: Department of Neurology, Nippon Medical School, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D020820:Dyskinesias / Q000209:etiology*; D005121:Extremities / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000188:drug therapy; D020772:Internal Capsule / Q000473:pathology*; D008279:Magnetic Resonance Imaging
chemical_list: D005947:Glucose
keywords: Diffusion-weighted imaging; Hypoglycemia; Involuntary movement; Magnetic resonance imaging; Posterior limb of internal capsule; Spinal automatism