My 18 year old son has seizures during sleep (neurological testing shows nothing abnormal), low blood sugar, ketones in urine, and a trace of blood in urine. Can you tell me what these might mean?

Without knowing how low the blood sugars actually were it is difficult to be sure that it was hypoglycemia that triggered the seizures. It is certainly a possibility though and as a first step it would be important to see that he has an adequate evening meal and before bed a high protein, corn starch snack like the Extend Bar or NiteBite. The urine ketones rather suggested that he may have been eating inadequately. Hypoglycemia due to insufficient calories in the evening might well trigger seizures in someone who already had a familial or congenital disposition to epilepsy. An EEG [brain wave test] might help; but you must talk to his doctor about this.

There are of course a number of possibilities; but I imagine that you contacted this site because you thought that this might be due to diabetes. It is true that autoimmune diabetes in young adults can occasionally present with hypoglycemia which is due to a delayed first phase insulin release from damaged pancreatic islet cells. Simple tests for urine sugar or of a fasting blood sugar might rule out the diagnosis; but especially if there is any family history of this form of diabetes or if you wanted to be quite sure you should again talk to the doctor about getting an antibody test done. The number to call for more information is 1-800-425-8361.

DOB