Published Online
on February 3, 2005

A more recent version of this article appeared on March 1, 2005

This Article Full Text (PDF) All Versions of this Article: 36/3/e20    most recent 01.STR.0000155733.65215.c2v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Böttcher, J. Articles by Kaiser, W. A. Search for Related Content PubMed PubMed Citation Articles by Böttcher, J. Articles by Kaiser, W. A. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Hypoglycemia Related Collections Type 2 diabetes Brain Circulation and Metabolism Computerized tomography and Magnetic Resonance Imaging

Submitted on November 21, 2004
Accepted on November 25, 2004

Localized Reversible Reduction of Apparent Diffusion Coefficient in Transient Hypoglycemia-Induced Hemiparesis

J. Böttcher MD^*; A. Kunze MD; C. Kurrat MD; P. Schmidt MD; G. Hagemann MD; O. W. Witte MD; and W. A. Kaiser MD, MS

From the Department of Diagnostic and Interventional Radiology (J.B., C.K., P.S., W.A.K.), and Department of Neurology (A.K., G.H., O.W.W.), Friedrich-Schiller-University Jena, Germany.

^* To whom correspondence should be addressed. E-mail: joachim.boettcher{at}med.uni-jena.de.

Background and Purpose--The pathophysiology of hypoglycemia shares a common mechanism with cerebral ischemia, but so far, little is known regarding MRI of humans with hypoglycemia.

Methods--We report a patient with left hemiparesis and dysarthria associated with a blood glucose level of 1.7 mmol/L. The patient recovered completely after glucose infusion.

Results--The initial diffusion-weighted imaging (DWI) showed increased signal intensities and a reduction of apparent diffusion coefficient (ADC) values localized in the corpus callosum (splenium) and asymmetrically in the corona radiata. After 48 hours, follow-up revealed complete recovery of DWI and ADC signal abnormalities.

Conclusion--To our knowledge, this is the first presentation of a case with transient hypoglycemia-induced focal neurological deficits revealing completely reversible MRI changes in terms of disturbed DWI and ADC with a peculiar as yet undescribed topography.

Key words: apparent diffusion coefficient • diffusion-weighted imaging • hypoglycemia • magnetic resonance imaging

This article has been cited by other articles:

				J Maruya, H Endoh, H Watanabe, H Motoyama, and H Abe Rapid improvement of diffusion-weighted imaging abnormalities after glucose infusion in hypoglycaemic coma BMJ Case Reports, January 22, 2009; 2009(jan21_1): bcr0720080514 - bcr0720080514. [Abstract] [Full Text]

				C. C. T. Lim, R. Gan, C. L. Chan, A. W. K. Tan, J. J. C. Khoo, S.-Y. Chia, S. L. Kao, J. Abisheganaden, and Y. Y. Sitoh Severe Hypoglycemia Associated with an Illegal Sexual Enhancement Product Adulterated with Glibenclamide: MR Imaging Findings Radiology, January 1, 2009; 250(1): 193 - 201. [Abstract] [Full Text] [PDF]

				J Maruya, H Endoh, H Watanabe, H Motoyama, and H Abe Rapid improvement of diffusion-weighted imaging abnormalities after glucose infusion in hypoglycaemic coma J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 102 - 103. [Full Text] [PDF]

				G. Hagemann, H.-J. Mentzel, H. Weisser, A. Kunze, and C. Terborg Multiple Reversible MR Signal Changes Caused by Epstein-Barr Virus Encephalitis AJNR Am. J. Neuroradiol., August 1, 2006; 27(7): 1447 - 1449. [Abstract] [Full Text] [PDF]

				C. Cordonnier, C. Oppenheim, C. Lamy, J. -F. Meder, and J. -L. Mas Serial diffusion and perfusion-weighted MR in transient hypoglycemia Neurology, July 12, 2005; 65(1): 175 - 175. [Full Text] [PDF]