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April 11, 2005

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Question from Rector, Arkansas, USA:

My son, now eight, started having fainting spells at age four. He only does it in the morning. I have had a CT of the head done and an EEG in 2002. Everything came back normal. He has not had an episode since, until today. His blood sugar was 90 mg/dl [5.0 mmol/L] two hours after eating three bites of pancakes with syrup. I am really concerned and am wondering about a treatment. My doctor told me it may be hypoglycemia, but I want to know!

Answer:

Could it be hypoglycemia or could it be some type of seizure disorder? The CT and EEG are reassuring, but intermittent problems may not be detected. A 24 hour EEG may be helpful and a pediatric neurology consultation would be helpful. It is unclear from the information you have provided.

If you suspect hypoglycemia, then you have to catch an episode and get an immediate blood glucose level to know for sure. It would be reasonable to get some testing done by your physician and/or consult a pediatric endocrinologist who works with such young children. It would also be reasonable to learn how to do finger stick blood glucose tests and do a detailed series for about a week and see what levels are naturally occurring, to see if there is any suggestion of hypoglycemia.

SB