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MRI abnormality of the bilateral middle cerebellar peduncles and long‐term follow‐up in hypoglycemic encephalopathy: A case report
Author(s) -
Sugimoto Takamichi,
Morikawa Yuria,
Ishikawa Ruoyi,
Abe Takafumi,
Ohno Narumi,
Giga Mayumi,
Naito Hiroyuki,
Kono Tomoyuki,
Nomura Eiichi,
Yamawaki Takemori
Publication year - 2021
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12467
Subject(s) - medicine , cerebellar ataxia , abnormality , cerebellum , magnetic resonance imaging , ataxia , internal capsule , encephalopathy , ataxic gait , anatomy , radiology , psychiatry , white matter
A 32‐year‐old woman had a medical history of a hypoglycemic attack. One year later, she had a second hypoglycemic attack. She could move her limbs after an intravenous glucose injection, but communication difficulty and cerebellar ataxia remained. We found brain MRI abnormalities in the bilateral middle cerebellar peduncles and internal capsule. The patient was diagnosed with insulinoma. High‐intensity MRI fluid‐attenuated inversion recovery at the bilateral middle cerebellar peduncles remained on the 45th day, but it disappeared after 1.7 years from the second attack. Consciousness improved, but cerebellar ataxia remained. The patient was able to walk without a cane following rehabilitation. There are few case reports of MRI abnormalities in the bilateral middle cerebellar peduncles in hypoglycemic encephalopathy. This case showed that infratentorial lesions, such as those in the middle cerebellar peduncles, might be observed on MRI in hypoglycemic encephalopathy that MRI abnormalities might disappear at long‐term follow‐up.