BMJ Case Reports 2016; doi:10.1136/bcr-2016-217245

Hypoglycaemic injury spares thalamus, spoils striatum and leaves only a rest tremor

  1. Laura S Boylan
  1. Department of Neurology, New York University School of Medicine, New York, USA
  1. Correspondence to Dr Laura S Boylan, laura.boylan{at}
  • Accepted 25 August 2016
  • Published 9 September 2016


A patient was found unresponsive but breathing with blood glucose of 45 mg/dL following insulin overdose. On unsedated examination the following day the patient's eyes were roving with limbs flaccid. The best responsiveness was triple flexion withdrawal of the left leg to deep nail bed pressure. There was a continuous symmetric low amplitude 3–4 Hz pill-rolling type rest tremor of both hands.

To the best of the author's knowledge this is the first report of rest tremor …

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