Neuroglycopaenia presenting as isolated aphasia

Abstract

Aphasia is an uncommon presentation of neuroglycopaenia. We herein report a case of a 55-year-old man with type 2 diabetes mellitus with neuroglycopaenia presenting with speech difficulties that recovered over an unusually prolonged period. The clinical course and laboratory results are presented. The patient's symptoms persisted for 48 hours despite correction of hypoglycaemia but he made significant recovery. This case highlights an unusual presentation of neuroglycopaenia manifesting mainly with extended speech deficits. The delayed recovery despite correction of hypoglycaemia in this patient shows that Whipple's Triad may not be reliably applied in patients treated with long-acting insulin secretagogues or those with neuronal vulnerability to hypoglycaemia.