RESUMO
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.
Assuntos
Hipoglicemia/complicações , Ataque Isquêmico Transitório/etiologia , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Encéfalo/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico , Diagnóstico Diferencial , Teste de Tolerância a Glucose , Humanos , Hipoglicemia/diagnóstico , Hipoglicemia/dietoterapia , Imageamento por Ressonância Magnética , Masculino , Fatores de Risco , Ultrassonografia DopplerRESUMO
We present a case of a 74-year-old man who was admitted to our stroke unit with symptoms and signs suggestive of a left total anterior circulation stroke. Subsequent MRI failed to support this diagnosis and, furthermore, correction of an incidental finding of hyponatraemia due to syndrome of inappropriate antidiuretic hormone secretion led to a complete recovery of symptoms. Investigation and subsequent exclusion of other potential differential diagnoses confirmed the diagnosis of hyponatraemia mimicking acute stroke.