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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Case of steroid-responsive encephalopathy from hypoglycaemia
  1. Jay L Mathur1,
  2. Fereshteh Rajabi1,
  3. Allison Schroeder2,
  4. Torben K Becker3
  1. 1Department of Internal Medicine, UPMC Mercy, Pittsburgh, Pennsylvania, USA
  2. 2Department of Physical Medicine and Rehabilitation, UPMC Presbyterian, Pittsburgh, Pennsylvania, USA
  3. 3Department of Critical Care Medicine, UPMC Presbyterian, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Jay L Mathur, JLMathur{at}gmail.com

Summary

Hypoglycaemic encephalopathy is a feared complication in the management of patients with diabetes mellitus. We report on a 73-year-old woman with type 1 diabetes managed with an insulin pump who presented unresponsive after an inappropriate insulin bolus. The patient had minimal improvement in her neurological status over 8 days. After administration of 1 g intravenous methylprednisolone, she had dramatic neurological improvement including successful extubation and discharge from the intensive care unit. Steroid responsive encephalopathy is increasingly recognised in practice and literature. However, to the best of our knowledge, this is the first case of hypoglycaemic encephalopathy that responded to high-dose steroids.

  • diabetes
  • neurological injury
  • neurology (drugs and medicines)

https://doi.org/10.1136/bcr-2017-221262

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    Footnotes

    • Contributors All authors have seen and approve of the manuscript submitted and contributed greatly to it. Contributions are listed with specific authors that contributed. Conception and design of case report and manuscript, acquisition of data, analysis and/or interpretation of data, drafting the manuscript, revising the manuscript critically for important intellectual content, approval of the version of the manuscript to be published: all authors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.