My 17 month old daughter had a seizure at eight weeks and again very recently. After the first one, paramedics thought she was just choking on saliva and released her without testing her blood. The next day, our doctor did request an EEG, which showed normal readings. During this last seizure, paramedics got a blood sugar reading. Her blood level was documented at 20 mg/dl [1.1 mmol/L]. It stayed very low for several hours in the Emergency Room, even after being administered glucose. We are scheduled for a series of tests, but, in the meantime, my questions are these: (1) does this sound like hypoglycemia; (2) could she have experienced permanent brain damage; (3) could the low blood sugar cause the seizure or did the seizure cause the low blood sugar; and (4) if we are going to have another EEG, should we wait or would an MRI be a better option?

You did not mention that your child had diabetes. If this were a hypoglycemic seizure in someone with diabetes, then this obviously requires detective work to determine why there is insufficient food and excess insulin at these times. If this were not diabetes, then a blood glucose of 20 mg/dl [1.1 mmol/L] is extremely low and this fulfills the criteria for a hypoglycemic seizure – and would then be the presumed cause of the seizures. The key question is why is she hypoglycemia and to this degree. This is an emergency situation and so that this does not recur, you should immediately contact your primary care provider and a pediatric endocrinologist who can help figure this out. The pituitary gland, adrenal gland, and pancreas are highest on list to check. Seizures, if they do anything directly to blood sugar levels, would make them high since a seizure/convulsion is obviously a major stress event to the body.

SB