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NEUROENDOCRINOLOGY
LETTERS
including
Psychoneuroimmunology, Neuropsychopharmacology,
Reproductive Medicine, Chronobiology
and Human Ethology, ISSN 0172–780X
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NEL
Vol.24 No.1/2, Feb-Apr 2003
CASE REPORT
Repeated
hypoglycemia and cognitive decline. A Case Report
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2003;
24:54–56
pii: NEL241203C01
PMID: 12743533
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Repeated
hypoglycemia and cognitive decline
A Case Report
A. Akyol 1, N. Kiylioglu 1, O. Bolukbasi
2, E. Guney 2
& Y. Yurekli 3
Adnan
Menderes University, Medical Faculty, TURKEY.
1. Department of Neurology
2. Department of Endocrinology
3. Department of Nuclear Medicine
Submitted:
February 13, 2002 Accepted: February 26, 2002
Key
words:
hypoglycemia, cognitive failure, type 1 diabetes mellitus
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Abstract
OBJECTIVE:
Diabetes mellitus has a high incidence in general population
and goes by high morbidity by specific micro vascular pathology
in the retina, renal glomerul and peripheral nerves. In type
1 DM, intensive therapy can prevent or delay the development
of long-term complications associated with DM but hypoglycaemia
especially severe hypoglycaemia defined, as a low blood glucose
resulting in stupor, seizure, or unconsciousness that precludes
self-treatment is a serious threat. Hypoglycaemia that may
preferentially harm neurons in the medial temporal region,
specifically the hippocampus, is a potential danger for the
brain cognitive function which several studies failed to detect
any significant effects, whereas others indicated an influence
on it. A young diabetic case presented here with severe cognitive
defect. Great number of severe hypoglycaemic or hyperglycaemic
attacks and convulsion episodes were described in his medical
history.
RESULTS
and CONCLUSION: Neuroradiologic findings on CT and MRI, pointed
that global cerebral atrophy that is incompatible with his
age. Brain perfusion studies (SPECT, 99mTc-labeled HMPAO)
also showed that there were severe perfusion defects at superior
temporal region and less perfusion defects at gyrus cingulim
in frontal region. These regions are related with memory processing.
Severe cognitive defect in this patient seems to be closely
related these changes and no another reason was found to explain
except the repeated severe hypoglycaemic episodes.
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__________________________________________________________
Copyright © Neuroendocrinology Letters 2003
Society of Integrated Sciences
All rights reserved. No part may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means,
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without prior written permission from the Editor-in-Chief.
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