MRI abnormality of the bilateral middle cerebellar peduncles and long‐term follow‐up in hypoglycemic encephalopathy: A case report

Abstract

AbstractA 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.