My daughter is four years old. She began having seizures when she was two. At that time and several times since then, we have asked her pediatrician and her neurologist if the seizures could be related to diabetes. We have a family history of adult onset diabetes, two great grandmothers and one grandmother. Both the pediatrician and the neurologist have suggested that this could not be the cause of the seizures and have not tested for diabetes. Her diagnosis is idiopathic mixed seizure disorder and she takes Depakote [an antiseizure medication]. Until recently these seizures have been very well controlled by this anticonvulsant. We have found that if she is given frequent small small snacks (such as crackers, fruit or yogurt) she has fewer seizures and is more coherent in general. Is it possible that she could have a blood sugar problem that is causing the seizures? If this is a possibility, how can we persuade her pediatrician or neurologist to test her? Can you recommend any literature to help me understand how blood sugar might relate to seizures?

I would have to agree with your daughter’s doctors, that her seizures are not related to any form of diabetes. It is true that the central nervous system is very dependant on glucose as an energy source so that hypoglycemia can certainly bring about brain damage, especially in the early years of life. However, hypoglycemia (as opposed to hyperglycemia) is essentially unknown as a feature of diabetes at this age unless a child has already started on insulin. Finally, of course, her older relatives would be very unlikely to suffer from the autoimmune form of diabetes which is by far the commonest form in childhood.

As to literature, which I don’t think you need, you might like to consult Peter Chase’s Understanding Insulin-Dependent Diabetes which you can read or download without charge.

Early hypoglycemia from some other cause might of course bring about a story like this, and I am sure the doctors would have considered it at the beginning. It is nearly always associated with some specific abnormality on physical examination or with some other evidence of a metabolic disorder.

DOB
Additional Comments from Dr. John Schulga

The history suggests that it may be worth making sure that there isn’t a metabolic cause for your child’s seizures. Sometimes if the body is unable to handle fats properly, the blood sugar level may fall and could lead to seizures. It might be worth mentioning this to your paediatrician. However, this is unrelated to diabetes.

JS