Central pontine myelinolysis and ataxia: an unusual manifestation of hypoglycaemia

Abstract

Hypoglycaemia is common in people with diabetes who aim to achieve good blood glucose control. Severe hypoglycaemia presents with evidence of neurological dysfunction, such as inability to concentrate, confusion, seizures, and coma. Such disturbances are reversible on correction of the hypoglycaemia. Infrequently there may be a focal neurological deficit and we report one such case presenting with cerebellar symptoms following an episode of severe hypoglycaemia. A magnetic resonance scan showed features consistent with the presence of central pontine myelinolysis. The symptoms resolved within a few months with only minimal residual neurological deficit.