Transient interhemispheric disconnection in a case of insulinoma-induced hypoglycemic encephalopathy

Chikara Yamashita, Hiroshi Shigeto, Norihisa Maeda, Minako Kawaguchi, Mitsue Uryu, Satoru Motomura, Jun-Ichi Kira

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We report a case of a 22-year-old male who was transferred to our hospital in a comatose state following successive seizures. Low blood glucose had been detected upon his arrival at the previous hospital. He became responsive 12 days after the onset of coma. Upon regaining consciousness he exhibited severe dysarthria and several interhemispheric disconnection signs such as intermanual conflict, left-hand dysgraphia, left hemispatial neglect confined to the right hand, impaired interhemispheric transfer, and unilateral constructional apraxia of the right hand. Brain MRI disclosed T2-weighted and diffusion-weighted hyperintense lesions with reduced apparent diffusion coefficients in the bilateral centrum semiovale, splenium of the corpus callosum, right posterior limb of the internal capsule, and bilateral middle cerebellar peduncles. As the MRI findings vanished, his interhemispheric disconnection signs gradually resolved. Abdominal imaging studies revealed a pancreatic tumor, which was later endocrinologically diagnosed as an insulinoma. This is an extremely rare report of interhemispheric disconnection signs due to hypoglycemic encephalopathy. The lesions in the bilateral centrum semiovale likely contributed to the interhemispheric disconnection signs.

Original languageEnglish
Pages (from-to)233-237
Number of pages5
JournalJournal of the Neurological Sciences
Volume335
Issue number1-2
DOIs
Publication statusPublished - Dec 15 2013

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Insulinoma
Brain Diseases
Hypoglycemic Agents
Hand
Coma
Perceptual Disorders
Agraphia
Internal Capsule
Apraxias
Dysarthria
Corpus Callosum
Consciousness
Blood Glucose
Seizures
Extremities
Brain
Neoplasms

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Transient interhemispheric disconnection in a case of insulinoma-induced hypoglycemic encephalopathy. / Yamashita, Chikara; Shigeto, Hiroshi; Maeda, Norihisa; Kawaguchi, Minako; Uryu, Mitsue; Motomura, Satoru; Kira, Jun-Ichi.

In: Journal of the Neurological Sciences, Vol. 335, No. 1-2, 15.12.2013, p. 233-237.

Research output: Contribution to journalArticle

Yamashita, Chikara ; Shigeto, Hiroshi ; Maeda, Norihisa ; Kawaguchi, Minako ; Uryu, Mitsue ; Motomura, Satoru ; Kira, Jun-Ichi. / Transient interhemispheric disconnection in a case of insulinoma-induced hypoglycemic encephalopathy. In: Journal of the Neurological Sciences. 2013 ; Vol. 335, No. 1-2. pp. 233-237.
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