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Transient Hypoglycemic Hemiplegia

Arch Intern Med. 1964;114(5):680-684. doi:10.1001/archinte.1964.03860110150017.
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In this paper, the clinical features and the theories of pathogenesis of transient hypoglycemic hemiplegia will be summarized.

Report of a Case 

History.  —A 22-year-old white male was hosiptalized because of the sudden development of hemiplegia. He was a ketosis-prone diabetic of nine years' duration. On many occasions, he had had insulin reaction manifested by hunger, palpitation, sweating, and stupor. He had increased his dose of insulin zinc suspension extended (Ultralente Iletin) four days prior to admission, and 16 hours after the administration of insulin, he developed sudden and severe weakness of the right limbs. Neither he nor the family had detected any of the usual warning signs of an insulin reaction.The past history was unremarkable.There was no family history of diabetes mellitus.

Physical Examination.  —The patient was alert and well oriented. Expressive aphasia was present. The skin was dry and the temperature and pulse rate were normal.


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