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Reminder of important clinical lesson
CASE REPORT
Reactive hypoglycaemia: a rarely considered ‘stroke mimic’ in non-diabetic individuals
  1. William Wareing1,
  2. Brian Ho1,
  3. David Ewins2,
  4. Kausik Chatterjee1
  1. 1Care of the Elderly Department, Countess of Chester Hospital NHS Foundation Trust, Chester, UK
  2. 2Diabetes and Endocrinology Department, Countess of Chester Hospital NHS Foundation Trust, Chester, UK
  1. Correspondence to Dr William Wareing, william.wareing{at}nhs.net

Summary

Hypoglycaemia is a well-documented ‘stroke mimic’. The literature documents numerous case reports of patients presenting with focal neurological deficits subsequently attributed to hypoglycaemia. The significant majority of these cases are found in patients with pre-existing diabetes. We present case histories of two patients with no history of diabetes presenting to secondary care with reactive hypoglycaemia causing transient symptoms that were responsible for referral as a possible transient ischaemic attack. Although uncommon, metabolic disturbances such as hypoglycaemia should be considered in all patients presenting as a suspected stroke, even if they are not known to have diabetes.

  • metabolic disorders
  • stroke

https://doi.org/10.1136/bcr-2017-223955

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    Footnotes

    • Contributors The case series was compiled by KC after initial discussions with DE regarding differential diagnoses for the presentations described. WW: wrote initial paper including abstract, background, case 1 and discussion. BH: wrote case 2, obtained patient consent and created graphical form of extended glucose tolerance test results. DE: diagnostic work-up, analysis and evaluation of glucose tolerance test results and reviewed final manuscript. KC: reviewed and edited manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

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