What are the symptoms of hypoglycemic encephalopathy?

Hypoglycemic encephalopathy is mainly caused by damage to brain tissue due to severe hypoglycemia. Common clinical symptoms include sweating, tremors or blurred vision, and pale complexion. Therefore, people who often show these symptoms must pay attention to them.

1. Pathology

Glucose is the main source of energy for the brain, especially the cerebrum, but the ability of brain cells to store glucose is very limited and can only maintain the energy needs of brain activity for a few minutes. Therefore, the main source of energy for the brain is blood sugar. Prolonged severe hypoglycemia can seriously damage brain tissue. In the early stages of sugar deficiency in the brain tissue, congestion and multiple hemorrhagic ecchymoses may occur; then, due to damage to the Na+-K+ pump in the brain cell membrane, a large amount of Na+ enters the brain cells, followed by cerebral edema and punctate necrosis of the brain tissue; in the late stages, nerve cells necrotize and disappear, resulting in softening of the brain tissue. Different parts of the nervous system have different sensitivities to hypoglycemia. The cerebral cortex, hippocampus, cerebellum, caudate nucleus and globus pallidus are the most sensitive, followed by the cranial nerve nuclei, thalamus, hypothalamus and brainstem. The spinal cord is less sensitive. The damage caused by hypoglycemia to the brain is similar to that caused by ischemic brain damage, but not exactly the same. However, severe hypoglycemia is often accompanied by a decrease in the brain's oxygen uptake rate, which makes the brain less tolerant to hypoxia and can further aggravate the damage of hypoglycemia to the brain.

2. Clinical manifestations

1. Sympathetic nerve excitement symptoms

The main symptoms include sweating, trembling, blurred vision, hunger, weakness and tension, pale complexion, palpitations, nausea, vomiting and cold limbs.

2. Symptoms of brain hypoxia and sugar deficiency

The main symptoms are headache, dizziness and forgetfulness. Mental disorder, gradual loss of orientation and memory, fear, panic, hallucinations and mania, etc. There may be clonic, choreiform or childish movements, tachycardia, mydriasis, positive pyramidal tract signs, etc. Patients may experience epileptic symptoms, confusion, drowsiness, or even coma, and may even experience deep coma, decerebrate rigidity, disappearance of various reflexes, shallow and weak breathing, decreased blood pressure, and pupil constriction. If the brain tissue is in a severe hypoglycemic state for a long time, it will be difficult for the patient to recover. Patients often suffer from symptoms such as memory loss, intellectual impairment, mental disorder or personality change. Unexplained idiopathic (or functional) hypoglycemia often occurs in children around 10 years old.