A month and a half ago, my 22 year old brother, who has had diabetes since he was 11 years old, had a seizure while sleeping and was quite combative during the seizure. His blood sugar level was 3.6 mmol/L [65 mg/dl] when the paramedics checked. Last week, he had another seizure, again while he was sleeping, and his blood sugar level was again 3.6 mmol/L [65 mg/dl]. What is causing these seizures now? He hasn’t had any before this.

His seizures could either be from hypoglycemia or another neurologic disorder causing seizures. Although the glucose was 3.6 mmol/L [65 mg/dl], the sugar could have been a whole lot lower at the time of the seizure. I think he may have been lower, and he has to be aggressively monitored for intermittent low sugars. I would suggest he sees his physician about a comprehensive strategy to address this problem. Outside the risk of hypoglycemia, I would recommend he have imaging procedures of his central nervous system and an EEG to see if another cause is evident. The answers are not in yet, from the description given.

JTL

[Editor’s comment: Your brother’s situation might be clarified by monitoring sugar levels continuously for several days to try to sort out what’s happening in more detail. See The Continuous Glucose Monitoring System. He should ask his doctor about using it.

SS]