Journal of the Korean Society of Magnetic Resonance in Medicine  2014;18(4):357-361

doi:10.13104/jksmrm.2014.18.4.357

Rapid Regression of White Matter Changes in Hypoglycemic Encephalopathy.

Sang Wook SON 1 ; Kye Ho LEE ; Dong Soo YOO

Affiliations

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Keywords

Hypoglycemic encephalopathy; Diffusion-weighted image; White matter

Country

Republic of Korea

Language

English

Abstract

PURPOSE: In a previous report, it took several days for white matter lesions to regress in hypoglycemic encephalopathy. We present a case of rapid diffusion-weighted image (DWI) changes in hypoglycemic encephalopathy. CASE REPORT: A 58-year-old male patient was found semi-comatous with the only abnormality in his laboratory tests showing hypoglycemia (44 mg/dL). After rapid correction of glucose level, immediate brain DWI showed bilateral subcortical white matter lesions. After about 5 hours, follow-up DWI showed resolved subcortical white matter lesions, with newly-appeared bilateral fronto-temporo-parietal cortical lesions. CONCLUSION: Both white matter and cortex involvement in hypoglycemic encephalopathy has been shown in several reports, but rapid regression of white matter changes in hypoglycemic encephalopathy has been rarely reported. It is important to know that MR imaging changes in hypoglycemic encephalopathy can be made as quick as just a few-hour-long.