An Atypical Case of Neonatal Hypoglycemic Encephalopathy with Extensive White Matter Lesions

Abstract

Neonatal hypoglycemia is a common condition that constitutes one of the leading causes of brain injury. Symptomatic hypoglycemia may present with metabolic encephalopathy characterized by neurological features, including stupor, jitteriness, seizures, apnea, irritability, and muscular hypoto-nia mimicking several other diseases. The typical magnetic resonance imaging (MRI) patterns of neonatal hypoglycemic encephalopathy (NHE) are signal abnormalities localized to the parietal and occipital lobes and progressive parenchymal loss of the predominant occipital lobe in the new-born. Diffusion-weighted imaging (DWI) may show restricted diffusion in the involved areas. These brain lesions are transient, and the revers-ibility of DWI has also been reported [1]. The patterns of injury associated with NHE are more diverse than those previously reported, and in-clude white matter, cortical, and basal ganglia/ thalamic abnormalities, white matter hemorrhage, and middle cerebral artery territory infarctions [2]. However, no reports of