Hypoglycaemia as a possible cause of transient ischaemic attack in a patient with multiple vascular risk factors.

An elderly, fibrillating, diabetic hypertensive patient in heart failure is at risk of stroke from all her cardiovascular morbidities. When such a patient presents with stroke, it is usually difficult to squarely incriminate one. Consequently, precious time is lost while care givers conduct expensive investigations to make a definitive diagnosis. This case report is on one such patient, in whom hypoglycaemia was a plausible cause. Treatment resulted in dramatic recovery. Had neurological complication of drug induced hypoglycaemia not been suspected, the hemiplegia might have become permanent; and any of her risk factors given as a rational explanation. Therefore when a diabetic on treatment presents with stroke, care givers should perform immediate blood glucose test to exclude hypoglycaemia; not withstanding the existence of other risk factors.