Symmetrical T2/FLAIR hyperintensity involving bilateral insular cortex, anterior and medial temporal lobe and basal ganglia with restricted diffusion on DWI and sparing of thalamus suggest hypoglycemic encephalopathy. The patient was hypoglycemic and random blood sugar (RBS) was 30 mg/dL.

Hypoxia can also have similar findings on imaging however it involves the thalamus and cerebellum in particular. It is often associated with a history of cardiac arrest.