ABSTRACT
Hypoglycemia sometimes manifests as focal neurologic deficits simulating cerebrovascular disease. Symptoms are usually resolved by glucose infusion, but persistent hemiplegia is rarely reported. A 68-year-old diabetic woman on oral hypoglycemic agent(OHA) was admitted with right hemiplegia and global aphasia. Blood glucose level was 29 mg/dl on admission. No evidence of cerebral infarct or underlying brain disease could be found on initial brain CT and follow up MRI. Focal stenosis or occlusion was also absent on MR angiography. Hemiplegia and aphasia were not improved despite adequate therapy. Hypoglycemic hemiplegia should be suspected in all diabetic patients using insulin or OHA with stroke-like episode, and we suggest that prolonged hypoglycemia may be related to persistence of neurologic deficits.
Subject(s)
Aged , Female , Humans , Angiography , Aphasia , Blood Glucose , Brain , Brain Diseases , Constriction, Pathologic , Follow-Up Studies , Glucose , Hemiplegia , Hypoglycemia , Insulin , Magnetic Resonance Imaging , Neurologic ManifestationsABSTRACT
Apolipoprotein E-epsilon4(APOE4) is recently known as a susceptibility gene or risk factor associated with late-onset Alzheimer's disease (AD). Association between APOE4 and probable AD was determined in Korean population. Twenty patients met the NINCDS-ADRDA probable AD criteria (M:F=7:13, Mean age: 70.1 yr)were compared with 146 controls without dementia (M:F=83:63, Mean age:63.6 yr). APOE genotype was determined by polymerase chain reaction and allele specific hybridization technique. APOE4 allele frequency (0.33 vs. 0.11, p<.01) and proportion of carriers with APOE4(60% vs. 19%, p<.01) were significantly increased in patient group. APOE4 genotype is also associated with late-onset sporadic AD in Korean, and APOE genotyping may be useful for differential diagnosis of AD for patients with dementia.