My son was diagnosed with dysphasia at age four. At age 12, he was diagnosed with hypoglycemia by our family doctor after an emergency hospital visit. His level was 50 mg/dl [2.89 mmol/L]. An endocrinologist refused to diagnose him officially because she believed there was no tumor present. He has been following a hypoglycemic diet and has been doing well. He is now 15 years old.

I recently found, through research, information regarding hypoglycemia mimicking stroke. I can certainly see those symptoms during bouts of very low blood sugar, but how about afterward? I have often questioned if my son had a stroke given his cognitive deficits (understanding spoken language, word order in expressive language) as well as speaking out of the side of his mouth, difficulty swallowing liquids properly, etc. He has made tremendous progress through homeschooling (gained three grade levels in 17 months), however, I am having great difficulty, despite the diagnosis of dysphasia, finding a speech therapist that knows what do to with him! They all try to claim an autism spectrum disorder which completely contradicts a neurologist at Children’s Hospital, a psychiatrist, and a clinical psychologist, saying he absolutely does not have that disorder.

If, in fact, the information regarding hypoglycemic mimicking stroke is accurate, it may help me in getting a more definitive diagnosis and proper help for my son.

It would be impossible to answer you questions without a great deal more information and specifically needing profiles of blood glucose levels for several days or weeks before and after eating. It certainly is possible that severe hypoglycemia causing coma, unconsciousness and/or convulsions, would appear like a stroke (lack of oxygen to the brain from a bleeding brain or neck blood vessel or an occluded brain or neck blood vessel). MRI and PET scans may help to assess whether or not this were occurring at the time and, sometimes, if there were scar tissue or lack of brain tissue to a specific area. When one thinks about hypoglycemia, one is always worried about conditions where there is excess insulin being produced (tumors, malformations of the pancreas, etc.), so, I suspect that this is what the endocrinologists were referring to originally and what was “ruled out” with their testing. If he functions better with eating every three hours, avoiding simple sugars and always providing some protein and fats with each meal and snack, then this is relatively easy to continue. If there were still a problem when the profile was reviewed with your endocrinologist, then further more detailed testing could be carried out. Other conditions that are associated with hypoglycemia (i.e., growth hormone deficiency, adrenal insufficiency, etc.) also should be considered. So, it is best to have your primary care physician try to coordinate such complicated issues or, alternatively, go back and re-consult with neurology, endocrinology, speech pathology, etc., and ask that they communicate with each other as well to try to decide what if anything should be done, approaches to take, etc.

SB