September 11, 2000
Hypoglycemia, Other Illnesses
Question from San Miguel de Tucum�n, Tucum�n, Argentina:
My niece is six years old and has had diabetes about a year. Until approximately four months ago, it was very controlled with normal dose of insulin. Since then, she began to get episodes of hyper- and hypoglycemia with big increases in the daily doses of insulin. Approximately one month ago, she began with episodes of absences with automatism [a special kind of seizure disorder] and the doctor is investigating neurologically if it is an epileptic crisis. Can a relationship exist between these crises of absences and the metabolic disorder that she evidences with the diabetes?
Answer:
The basic message here is that hypoglycaemia can cause unconsciousness and seizures. The latter are more likely if inappropriately large doses of insulin are used. Such seizures are not prima facie evidence of epilepsy but the latter can occur as a consequence of damage from multiple severe hypos. The distinction between primary epilepsy and hypo seizures can be difficult and is dependent upon a careful history of the attacks, concurrent blood sugars and/or EEG (brain wave) tracings.
KJR
