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KMID : 1130620100060020104
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Journal of Clinical Neurology
2010 Volume.6 No. 2 p.104 ~ p.108
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Lateralization of Hypoglycemic Encephalopathy: Evidence of a Mechanism of Selective Vulnerability
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Lee Seung-Hwan
Kang Chang-Don
Kim Sam-Soo
Tae Woo-Suk
Lee Seo-Young
Kim Seong-Heon
Koh Sung-Hye
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Abstract
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Background: One of the characteristics of hypoglycemic encephalopathy (HE) is selective vulnerability of different brain regions.
Case Report: 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.
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KEYWORD
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hypoglycemic encephalopathy, selective vulnerability, unilateral involvement, degree of metabolism
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