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July 23, 2003

Diagnosis and Symptoms

Question from Santa Ana, California, USA:

About six months ago, my 14 month old daughter had two seizures (on the same day) following a day of vomiting from a stomach virus.She spent several days in the hospital undergoing routine tests for seizures and thankfully all were negative. Finally, an endocrinologist told us the seizures were probably the result of low blood sugar from having fasted for 24 hours because of her illness.This left me terrified for fear that it will happen again if she ever contracts another virus. Two seizures seemed a bit extreme for a day of vomiting. Should she be tested for type 1 diabetes?

Answer:

Hypoglycemia is always on the list of possible causes of seizure, but, in view of all the negative tests and your daughter’s age, I personally think that this episode was one of febrile seizures consequent on the viral infection. Most pediatricians would not think it necessary to continue with any prophylactic anticonvulsant medication.

However, to relieve your anxiety, you should talk to your pediatrician about the possible use of a drug like diazepam at the onset of fever in the future and for the duration of the illness. I do not think not necessary to test for any form of diabetes.

DOB
Additional comments from Dr. Andrea Scaramuzza:

I don’t think it is necessary to test for type 1 diabetes. In fact, hypoglycemic seizures are due to a low level of blood glucose from fasting. If your becomes ill again, you can give her sugar beverages to avoid hypoglycemia.

AS
Additional comments from Dr. Larry Deeb:Ketotic hypoglycemia is well described. Fortunately, you can check for urine ketones in the urine. Don’t let her go to bed with ketones in the urine, and feed her if she has them.. She should outgrow the problem.

LD