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NEUROENDOCRINOLOGY LETTERS
including Psychoneuroimmunology, Neuropsychopharmacology,
Reproductive Medicine, Chronobiology
and Human Ethology, ISSN 0172–780X

NEL Vol.24 No.1/2, Feb-Apr 2003

CASE REPORT

Repeated hypoglycemia and cognitive decline. A Case Report

2003; 24:5456
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

 

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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