Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails
| Autor: | A. Gajjar Ritesh, K. Gurumukhani Jayanti, J. Mahadevia Himal, V. Patel Mukundkumar, M. Patel Maitri, M. Patel Dhruvkumar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry 030209 endocrinology & metabolism Guideline 03 medical and health sciences 0302 clinical medicine Hemiparesis Internal medicine Ischemic stroke medicine Cardiology Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Current Drug Therapy. 15:420-422 |
| ISSN: | 1574-8855 |
| DOI: | 10.2174/1574885515666191227155624 |
| Popis: | Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy. |
| Databáze: | OpenAIRE |
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