The
neurological manifestations complicated by profound hypoglycemia range from
reversible focal deficits to irreversible coma. The cortex, basal ganglia, and
hippocampus seem to be the brain tissues most vulnerable to hypoglycemia The
thalami, cerebellum, and hypothalamus are typically unaffected. Involvement of
the caudoputamen and basal ganglia may portend a poor prognosis.
The
localized lesions represent tissue degeneration, including some combination of
selective neuronal death, proliferation of astrocytic glial cells, paramagnetic
substance deposition, and/or lipid accumulation.