低血糖

Hypoglycemia

Point

・低血糖では，脳卒中に類似した片麻痺（低血糖性片麻痺）を呈することがある．

・低血糖性片麻痺では，MRIで内包に急性期脳梗塞と類似する所見がみられることもある．

・MRI異常所見が内包に限局している低血糖患者は，血糖補正により神経症状（意識障害や片麻痺）が速やかに改善する．

・MRI異常所見が皮質下白質にまで広がっている低血糖患者は，血糖を補正しても機能予後は不良である．

　Hypoglycemia may lead to acute hemiplegia. The most common diffusion-weighted MRI finding in patients with hypoglycemic hemiplegia is a hyperintense internal capsule lesion, which mimics acute ischemic stroke. In addition to the internal capsule lesion, various MRI findings have been reported in patients with hypoglycemia（including hyperintense lesions in the cerebral cortex, basal ganglia, subcortical white matter, and splenium of the corpus callosum）. It has recently been reported that hypoglycemic brain damage starts in the large white matter tracts, such as the internal capsule, and spreads to the entire brain, including the gray matter. However, the mechanism underlying the development of focal signs, such as hemiplegia in metabolic disorders, which affects the entire brain, remains unclear.