My 20 month old daughter has gross and small motor delays, and has seized, perhaps four times, possibly more. The neurologist would like to put her on medication. I am convinced she has a blood sugar problem. Is it possible to have muscle weakness and delays in development from severe low blood sugar? The last time she seized, she had an extreme bout of weakness when it was over which lasted about 15 minutes. She was not using her left hand as much.

You did not say whether there was any laboratory evidence that had led to your conviction that your daughter has a blood sugar problem. Certainly, it would be worth doing a fasting blood sugar level even though these are vulnerable to error at this age because the stress of a needle or lancet can very quickly raise blood sugar.

I rather doubt though that this is the primary problem. I do think you should discuss the possibility of getting an evaluation for some form of inherited metabolic disorder with the neurologist, especially if he does not have a specific diagnosis. I don’t know if there is a center that can evaluate these in Montana, but there certainly are in Seattle, Portland and Denver. It should be possible to evaluate this by sending serum and urine specimens without you and your daughter having to go personally, at least initially. Glutartic Aciduria Type II, Carnitine deficiency, medium chain Acyl CoA dehydrogenase deficiency and some of the mitochondrial disorders are individually very rare, but they can cause combinations of muscle weakness, hypoglycemia and developmental delay. Most importantly, they may be open to specific treatment.

DOB