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Multi‐modal brain imaging showing brain damage to the orbitofrontal cortex and left hemisphere, in a case of prolonged hypoglycemia‐induced transient hemiplegia followed by persistent encephalopathy
Author(s) -
Koike Shinsuke,
Sasaki Ryuichi
Publication year - 2013
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12057
Subject(s) - cerebral blood flow , neuroimaging , medicine , coma (optics) , electroencephalography , magnetic resonance imaging , encephalopathy , single photon emission computed tomography , brain damage , hypoglycemia , psychology , anesthesia , cardiology , radiology , psychiatry , insulin , physics , optics
A 21‐year‐old left‐handed male patient was admitted with a 19‐h history of coma after substantial insulin injection for suicide attempt. Although the patient recovered from coma 3 days after injury, he experienced transient hemiplegia followed by permanent brain damage. Electroencephalogram ( EEG ), brain magnetic resonance imaging ( MRI ), and brain single‐photon emission computed tomography ( SPECT ) identified the localization of this dysfunction, but consistency between clinical symptoms and brain images changed depending on the course of treatment. Transient hemiplegia corresponded to abnormal waveforms on EEG and decreased cerebral blood flow on SPECT , whereas persistent dysfunctions corresponded to abnormal brain regions on MRI and SPECT .