• Register
  • Login

Iranian Journal of Child Neurology

  • Home
  • About
    • About the Journal
    • Indexing & Abstracting
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Current
  • Archives
  • Announcements
Advanced Search
  1. Home
  2. Archives
  3. Vol. 19 No. 3 (2025): Summer
  4. Research Article

Vol. 19 No. 3 (2025)

Tir 2025

Hypoglycemic Seizure: Etiologies and Neurological Outcome in Two Differential Age of Children (Five Year Descriptive Study)

  • Nahideh Khosroshahi Khosroshahi
  • Masoumeh Hassani
  • Kamyar Kamrani
  • Zahra Haghshenas
  • Nika Keshtkaran
  • Simin Khayatzadeh Kakhki

Iranian Journal of Child Neurology, Vol. 19 No. 3 (2025), 25 Tir 2025 , Page 63-70
https://doi.org/10.22037/ijcn.v19i3.40128 Published: 2025-06-25

  • View Article
  • Download
  • Cite
  • References
  • Statastics
  • Share

Abstract

Objectives:

Hypoglycemia is a widespread pediatric emergency that can manifest in various ways. One of the most critical symptoms is the occurrence of seizures. Recognizing these episodes promptly is essential in managing the condition effectively. Physicians’ apprehension, specifically pediatricians’, can lead to early diagnosis and improve the prognosis by decreasing the neurologic aftermath. By presenting data and analysis on the prevalence of hypoglycemic seizures, triggers, and neurologic side effects, we plan to raise awareness of the issue. This study intends to demonstrate the leading causes of hypoglycemia and the major neurological sequels by assessing the prevalence of hypoglycemia in a children’s hospital center to raise awareness of the condition.

Materials & Methods:

This cross-sectional study was conducted with two parts: demographic data (age, gender), clinical presentations, and lab data (blood sugar) on seizure onset, cause of hypoglycemia, and comorbidities before admission. The second part was based on neurologic evaluation and sequela follow-up.

Results

Collectively, 79 pediatric patients were enrolled in the study, of which 51 were male (64.6%).44.3% had experienced a first episode of hypoglycemic seizures in neonacy, 24.05% in infancy, and 31.65% in childhood. In the neonatal period, poor intake, birth asphyxia, and IUGR are, respectively, the leading causes of hypoglycemic seizures. As for the infant-child group, the most common etiology was the following: diabetic patients treated with insulin, ketotic hypoglycemia, hyperinsulinism, and Glycogen Storage Disease (GSD), respectively. The most common sequelae were global psychomotor delay, isolated speech delay, and isolated motor delay, respectively.

Conclusion:

This study reveals that we can help prevent hypoglycemia by maternal education on breast-feeding and avoiding early patient discharge. Regarding the post-neonatal group, parental education on the proper application of insulin can prevent probable seizure and other consequences

Keywords:
  • neonatal seizure, developmental delay, hypoglycemic seizure, outcome, pediatric
  • pdf

How to Cite

Khosroshahi, N. K., Hassani, M. ., Kamrani, K. ., Haghshenas, Z. ., Keshtkaran, N. ., & Khayatzadeh Kakhki, S. (2025). Hypoglycemic Seizure: Etiologies and Neurological Outcome in Two Differential Age of Children (Five Year Descriptive Study). Iranian Journal of Child Neurology, 19(3), 63–70. https://doi.org/10.22037/ijcn.v19i3.40128
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

References

1. Adamkin, D.H., Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics, 2011. 127(3): p. 575-9.
2. Perlman J , V.J., Glucose:Metabolic Encephalopathies, in Volpes Neurology of the newborn, V. J, Editor. 2018, Elsevier: philadelphia. p. 703.
3. Arhan, E., et al., Neonatal hypoglycemia: A wide range of electroclinical manifestations and seizure outcomes. Eur J Paediatr Neurol, 2017. 21(5): p. 738-744.
4. Edwards, T. and J.E. Harding, Clinical Aspects of Neonatal Hypoglycemia: A Mini Review. Front Pediatr, 2020. 8: p. 562251.
5. Achoki, R., N. Opiyo, and M. English, Mini-review: Management of hypoglycaemia in children aged 0-59 months. J Trop Pediatr, 2010. 56(4): p. 227-34.
6. Rozance, P.J. and W.W. Hay, Jr., New approaches to management of neonatal hypoglycemia. Matern Health Neonatol Perinatol, 2016. 2: p. 3.
7. Levasseur, K.A., H. Tigchelaar, and N. Kannikeswaran, Persistent hypoglycemia. Pediatr Emerg Care, 2013. 29(7): p. 838-41.
8. Josefson, J. and D. Zimmerman, Hypoglycemia in the emergency department. Clinical Pediatric Emergency Medicine, 2009. 10(4): p. 285-291.
9. Herbel, G. and P.J. Boyle, Hypoglycemia. Pathophysiology and treatment. Endocrinol Metab Clin North Am, 2000. 29(4): p. 725-43.
10. Zammitt, N.N. and B.M. Frier, Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. Diabetes care, 2005. 28(12): p. 2948-2961.
11. Cryer, P.E., Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawareness. Endocrinol Metab Clin North Am, 1999. 28(3): p. 495-500, v-vi.
12. Gataullina, S., et al., Comorbidity and metabolic context are crucial factors determining neurological sequelae of hypoglycaemia. Dev Med Child Neurol, 2012. 54(11): p. 1012-7.
13. Suh, S.W., A.M. Hamby, and R.A. Swanson, Hypoglycemia, brain energetics, and hypoglycemic neuronal death. Glia, 2007. 55(12): p. 1280-6.
14. Schober, E., et al., Association of epilepsy and type 1 diabetes mellitus in children and adolescents: is there an increased risk for diabetic ketoacidosis? J Pediatr, 2012. 160(4): p. 662-666.e1.
15. McCorry, D., et al., An association between type 1 diabetes and idiopathic generalized epilepsy. Ann Neurol, 2006. 59(1): p. 204-6.
16. Vincent, A. and P.B. Crino, Systemic and neurologic autoimmune disorders associated with seizures or epilepsy. Epilepsia, 2011. 52 Suppl 3: p. 12-7.
17. Verrotti, A., et al., Seizures and type 1 diabetes mellitus: current state of knowledge. Eur J Endocrinol, 2012. 167(6): p. 749-58.
18. Eeg‐Olofsson, O., Hypoglycemia and neurological disturbances in children with diabetes mellitus. Acta Paediatrica, 1977. 66: p. 91-96.
19. Haumont, D., H. Dorchy, and S. Pelc, EEG abnormalities in diabetic children: influence of hypoglycemia and vascular complications. Clin Pediatr (Phila), 1979. 18(12): p. 750-3.
20. Habbick, B.F., A.S. McNeish, and J.B. Stephenson, Diagnosis of ketotic hypoglycaemia of childhood. Arch Dis Child, 1971. 46(247): p. 295-300.
21. Ağladıoğlu, S.Y., et al., Hyperinsulinemic hypoglycemia: experience in a series of 17 cases. J Clin Res Pediatr Endocrinol, 2013. 5(3): p. 150-5.
22. Kao, K.T., P.J. Simm, and J. Brown, Childhood insulinoma masquerading as seizure disorder. J Paediatr Child Health, 2014. 50(4): p. 319-22.
23. Odenwald, B., et al., Children with classic congenital adrenal hyperplasia experience salt loss and hypoglycemia: evaluation of adrenal crises during the first 6 years of life. Eur J Endocrinol, 2016. 174(2): p. 177-86.
24. Keil, M.F., et al., Hypoglycemia during acute illness in children with classic congenital adrenal hyperplasia. J Pediatr Nurs, 2010. 25(1): p. 18-24.
25. Cross, J.H., Seizures associated with hypoglycaemia and subsequent epilepsy. Dev Med Child Neurol, 2015. 57(2): p. 117-8.
26. Sabzehei, M.K., B. Basiri, and H. Bazmamoun, The Etiology, Clinical Type, and Short Outcome of Seizures in NewbornsHospitalized in Besat Hospital/Hamadan/ Iran. Iran J Child Neurol, 2014. 8(2): p. 24-8.
27. Marwah, A. and G. Gathwala, Symptomatic hypoglycemia causing brain injury in a term breast fed newborn following early discharge. Indian J Pediatr, 2011. 78(12): p. 1549-51.
28. Fong, C.Y. and A.S. Harvey, Variable outcome for epilepsy after neonatal hypoglycaemia. Dev Med Child Neurol, 2014. 56(11): p. 1093-9.
29. Gataullina, S., et al., Topography of brain damage in metabolic hypoglycaemia is determined by age at which hypoglycaemia occurred. Dev Med Child Neurol, 2013. 55(2): p. 162-6.
30. Yalnizoglu, D., et al., Neurologic outcome in patients with MRI pattern of damage typical for neonatal hypoglycemia. Brain Dev, 2007. 29(5): p. 285-92.
31. Sood, A., N. Grover, and R. Sharma, Biochemical abnormalities in neonatal seizures. Indian J Pediatr, 2003. 70(3): p. 221-4.
32. Su, C., et al., Long-term follow-up and mutation analysis of 27 chinese cases of congenital hyperinsulinism. Horm Res Paediatr, 2014. 81(3): p. 169-76.
  • Abstract Viewed: 132 times

Download Statastics

  • Linkedin
  • Twitter
  • Facebook
  • Google Plus
  • Telegram

Developed By

Open Journal Systems
  • Home
  • Archives
  • Submissions
  • About the Journal
  • Editorial Team
  • Contact
Powered by OJSPlus