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Hypoglycemic Peripheral Neuropathy

Hypoglycemic Peripheral Neuropathy Abstract PERIPHERAL neuropathy is a rare finding in spontaneous hypoglycemia, and only 22 patients have been reported in the literature (Table 1).1-12 The purpose of this communication is to report two additional cases and to analyze the clinical presentation of peripheral neurological symptoms that occasionally accompany spontaneous hypoglycemia. Report of Cases CASE 1.—A 49-year-old electroplater was admitted to the hospital on June 24, 1963. He had a history of eight attacks approximately evenly spaced over the preceding 3½ years. The attacks started with sudden jerking movements of the legs, followed by similar movements of the arms, lasting altogether ten minutes. Attacks during the preceding 18 months were more severe, lasted one-half hour, and were accompanied by mental confusion and partial amnesia. The movements were described by the patient's wife as partly writhing and partly jerking; in some attacks, he tore his clothes and fell. She noticed pallor but no References 1. Laroche, G.; LeLourdy; and Bussière, J.-A.: Les hypoglycémies spontanées chroniques , Presse Med 36:513-516 ( (April 25) ) 1928. 2. Blau, A.; Reider, N.; and Bender, M.B.: Extra-pyramidal Syndrome and Encephalographic Picture of Progressive Internal Hydrocephalus in Chronic Hypoglycemia , Ann Intern Med 10:910-920 ( (Dec) ) 1936.Crossref 3. Silfverskiöld, B.P.: "Polyneuritis Hypoglycemica": Late Peripheral Paresis After Hypoglycemic Attacks in Two Insulinoma Patients , Acta Med Scand 125:502-504 ( (Dec) ) 1946.Crossref 4. Levrat, M., and Brette, R.: Cancer langerhansien du pancréas avec hypoglycémie douleurs musculaires et myosite dégénérative d'origine metabolique , Presse Med 2:530-531 ( (July 31) ) 1948. 5. Lidz, T., et al: Muscular Atrophy and Pseudologia Fantastica Associated with Islet Cell Adenoma of the Pancreas , Arch Neurol Psychiat 62:304-313 ( (Sept) ) 1949.Crossref 6. Willner, V., and Weinstein, V.A.: Islet Cell Adenoma of the Pancreas With Increased Insulin Excretion in the Urine , New York J Med 50:1103-1106 ( (May 1) ) 1950. 7. Tom, M.I., and Richardson, J.C.: Hypoglycaemia From Islet Cell Tumour of Pancreas With Amyotrophy and Cerebrospinal Nerve Cell Changes: A Case Report , J Neuropath Exp Neurol 10:57-66 ( (Jan) ) 1951.Crossref 8. Barris, R.W.: Pancreatic Adenoma (Hyperinsulinism) Associated With Neuromuscular Disorders , Ann Intern Med 38:124-129 ( (Jan) ) 1953.Crossref 9. Trethowan, W.H.: Persistent Sensory Symptoms Following Spontaneous Hypoglycemia: Response to Chlorpromazine: Report of a Case , J Nerv Ment Dis 121:274-278 ( (March) ) 1955.Crossref 10. Mulder, D.W.; Bastron, J.A.; and Lambert, E.H.: Hyperinsulin Neuropathy , Neurology 6:627-635 ( (Aug) ) 1956.Crossref 11. Rosner, L., and Elstad, R.: The Neuropathy of Hypoglycemia , Neurology 14:1-6 ( (Jan) ) 1964.Crossref 12. Lambert, E.H.; Mulder, D.W.; and Bastron, J.A.: Regeneration of Peripheral Nerves With Hyperinsulin Neuronopathy: Report of a Case , Neurology 10:851-854 ( (Sept) ) 1960.Crossref 13. Moersch, F.P., and Kernohan, J.W.: Hypoglycemia: Neurologic and Neuropathologic Studies , Arch Neurol Psychiat 39:242-257 ( (Feb) ) 1938.Crossref 14. Tannenberg, J.: Comparative Experimental Studies on Symptomatology and Anatomical Changes Produced by Anoxia and Insulin , Proc Soc Exp Biol Med 40:94-96 ( (Jan) ) 1939.Crossref 15. Winkelman, N.W., and Moore, M.T.: Neurohistopathologic Changes With Metrazol and Insulin Shock Therapy: An Experimental Study on the Cat , Arch Neurol Psychiat 43:1108-1137 ( (June) ) 1940.Crossref 16. Wauchope, G.M.: Hypoglycaemia: Critical Review , Quart J Med 26:117-156 ( (Jan) ) 1933. 17. Baker, A.B.: Cerebral Damage in Hypoglycemia: Review , Amer J Psychiat 96:109-127 ( (July) ) 1939. 18. Stern, K.; Dancey, T.E.; and McNaughton, F.L.: Sensory Disturbances Following Insulin Treatment of Psychoses , J Nerv Ment Dis 95:183-191 ( (Feb) ) 1942.Crossref 19. Ziegler, D.K.: Minor Neurologic Signs and Symptoms Following Insulin Coma Therapy , J Nerv Ment Dis 120:75-78 ( (July-Aug) ) 1954.Crossref 20. BÜckmann, I.: Beriberisymptome bei der Hypoglycämietherapie der Schizophrenie , Nervenarzt 10:412-414 ( (Aug) ) 1937. 21. Kastan, M.: Electric Corpse Changes and Reactions on the Peripheral Nerves in Insulin Treated Schizophrenic Patients , J Nerv Ment Dis 92:630-637 ( (Nov) ) 1940.Crossref 22. Abood, L.G.: " Neuronal Metabolism ," in Handbook of Physiology: I. Neurophysiology , American Physiological Society, Washington, DC, 1960, pp 1815-1826. 23. Larrabee, M.G., and Klingman, J.D.: Metabolism of Glucose and Oxygen in Mammalian Sympathetic Ganglia at Rest and in Action , Elliott, K.A.C.; Page, I.H.; and Quastel, J.H. (eds.): Neurochemistry , Springfield, Ill: Charles C Thomas, Publisher, 1962, pp 150-176. 24. Tschirgi, R.D.: " Chemical Environment of the Central Nervous System ," in Handbook of Physiology: I. Neurophysiology , Washington, DC: American Physiological Society, 1960, pp 1865-1890. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Hypoglycemic Peripheral Neuropathy

Archives of Neurology , Volume 21 (2) – Aug 1, 1969

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1969.00480140021002
Publisher site
See Article on Publisher Site

Abstract

Abstract PERIPHERAL neuropathy is a rare finding in spontaneous hypoglycemia, and only 22 patients have been reported in the literature (Table 1).1-12 The purpose of this communication is to report two additional cases and to analyze the clinical presentation of peripheral neurological symptoms that occasionally accompany spontaneous hypoglycemia. Report of Cases CASE 1.—A 49-year-old electroplater was admitted to the hospital on June 24, 1963. He had a history of eight attacks approximately evenly spaced over the preceding 3½ years. The attacks started with sudden jerking movements of the legs, followed by similar movements of the arms, lasting altogether ten minutes. Attacks during the preceding 18 months were more severe, lasted one-half hour, and were accompanied by mental confusion and partial amnesia. The movements were described by the patient's wife as partly writhing and partly jerking; in some attacks, he tore his clothes and fell. She noticed pallor but no References 1. Laroche, G.; LeLourdy; and Bussière, J.-A.: Les hypoglycémies spontanées chroniques , Presse Med 36:513-516 ( (April 25) ) 1928. 2. Blau, A.; Reider, N.; and Bender, M.B.: Extra-pyramidal Syndrome and Encephalographic Picture of Progressive Internal Hydrocephalus in Chronic Hypoglycemia , Ann Intern Med 10:910-920 ( (Dec) ) 1936.Crossref 3. Silfverskiöld, B.P.: "Polyneuritis Hypoglycemica": Late Peripheral Paresis After Hypoglycemic Attacks in Two Insulinoma Patients , Acta Med Scand 125:502-504 ( (Dec) ) 1946.Crossref 4. Levrat, M., and Brette, R.: Cancer langerhansien du pancréas avec hypoglycémie douleurs musculaires et myosite dégénérative d'origine metabolique , Presse Med 2:530-531 ( (July 31) ) 1948. 5. Lidz, T., et al: Muscular Atrophy and Pseudologia Fantastica Associated with Islet Cell Adenoma of the Pancreas , Arch Neurol Psychiat 62:304-313 ( (Sept) ) 1949.Crossref 6. Willner, V., and Weinstein, V.A.: Islet Cell Adenoma of the Pancreas With Increased Insulin Excretion in the Urine , New York J Med 50:1103-1106 ( (May 1) ) 1950. 7. Tom, M.I., and Richardson, J.C.: Hypoglycaemia From Islet Cell Tumour of Pancreas With Amyotrophy and Cerebrospinal Nerve Cell Changes: A Case Report , J Neuropath Exp Neurol 10:57-66 ( (Jan) ) 1951.Crossref 8. Barris, R.W.: Pancreatic Adenoma (Hyperinsulinism) Associated With Neuromuscular Disorders , Ann Intern Med 38:124-129 ( (Jan) ) 1953.Crossref 9. Trethowan, W.H.: Persistent Sensory Symptoms Following Spontaneous Hypoglycemia: Response to Chlorpromazine: Report of a Case , J Nerv Ment Dis 121:274-278 ( (March) ) 1955.Crossref 10. Mulder, D.W.; Bastron, J.A.; and Lambert, E.H.: Hyperinsulin Neuropathy , Neurology 6:627-635 ( (Aug) ) 1956.Crossref 11. Rosner, L., and Elstad, R.: The Neuropathy of Hypoglycemia , Neurology 14:1-6 ( (Jan) ) 1964.Crossref 12. Lambert, E.H.; Mulder, D.W.; and Bastron, J.A.: Regeneration of Peripheral Nerves With Hyperinsulin Neuronopathy: Report of a Case , Neurology 10:851-854 ( (Sept) ) 1960.Crossref 13. Moersch, F.P., and Kernohan, J.W.: Hypoglycemia: Neurologic and Neuropathologic Studies , Arch Neurol Psychiat 39:242-257 ( (Feb) ) 1938.Crossref 14. Tannenberg, J.: Comparative Experimental Studies on Symptomatology and Anatomical Changes Produced by Anoxia and Insulin , Proc Soc Exp Biol Med 40:94-96 ( (Jan) ) 1939.Crossref 15. Winkelman, N.W., and Moore, M.T.: Neurohistopathologic Changes With Metrazol and Insulin Shock Therapy: An Experimental Study on the Cat , Arch Neurol Psychiat 43:1108-1137 ( (June) ) 1940.Crossref 16. Wauchope, G.M.: Hypoglycaemia: Critical Review , Quart J Med 26:117-156 ( (Jan) ) 1933. 17. Baker, A.B.: Cerebral Damage in Hypoglycemia: Review , Amer J Psychiat 96:109-127 ( (July) ) 1939. 18. Stern, K.; Dancey, T.E.; and McNaughton, F.L.: Sensory Disturbances Following Insulin Treatment of Psychoses , J Nerv Ment Dis 95:183-191 ( (Feb) ) 1942.Crossref 19. Ziegler, D.K.: Minor Neurologic Signs and Symptoms Following Insulin Coma Therapy , J Nerv Ment Dis 120:75-78 ( (July-Aug) ) 1954.Crossref 20. BÜckmann, I.: Beriberisymptome bei der Hypoglycämietherapie der Schizophrenie , Nervenarzt 10:412-414 ( (Aug) ) 1937. 21. Kastan, M.: Electric Corpse Changes and Reactions on the Peripheral Nerves in Insulin Treated Schizophrenic Patients , J Nerv Ment Dis 92:630-637 ( (Nov) ) 1940.Crossref 22. Abood, L.G.: " Neuronal Metabolism ," in Handbook of Physiology: I. Neurophysiology , American Physiological Society, Washington, DC, 1960, pp 1815-1826. 23. Larrabee, M.G., and Klingman, J.D.: Metabolism of Glucose and Oxygen in Mammalian Sympathetic Ganglia at Rest and in Action , Elliott, K.A.C.; Page, I.H.; and Quastel, J.H. (eds.): Neurochemistry , Springfield, Ill: Charles C Thomas, Publisher, 1962, pp 150-176. 24. Tschirgi, R.D.: " Chemical Environment of the Central Nervous System ," in Handbook of Physiology: I. Neurophysiology , Washington, DC: American Physiological Society, 1960, pp 1865-1890.

Journal

Archives of NeurologyAmerican Medical Association

Published: Aug 1, 1969

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