Paroxysmal sympathetic hyperactivity secondary to hypoglycemic encephalopathy: A case report

A 48-year-old male was admitted to our hospital due to a hypoglycemic coma. Although his blood glucose level was increased after glucose administration, his impaired consciousness persisted. Magnetic resonance imaging indicated hypoglycemic encephalopathy. On hospital Day 4, he exhibited paroxysmal hypertension, tachycardia, hyperthermia, tachypnea, excessive diaphoresis, and hyperglycemia. Cerebrospinal fluid analysis and electroencephalography were nonspecific, suggesting paroxysmal sympathetic hyperactivity (PSH) secondary to hypoglycemic encephalopathy. Although PSH following hypoglycemic encephalopathy is rare, clinicians should be aware of its possibility to enable timely intervention and improve prognosis.