1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-4-90-a 10.15844/pedneurbriefs-4-12-2 Metabolic and Degenerative Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Focal Neurologic Deficits with Hypoglycemia and Diabetes http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 12 1990 01 08 2016 4 12 90 90 Copyright: © 1990 The Author(s) 1990 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Focal neurologic deficits associated with hypoglycemia in children with diabetes

Focal neurologic deficits on 19 occasions in seven children with diabetes are reported from Children’s Hospital, Winnipeg, Manitoba, Canada.

 Focal Neurologic Deficits Seizure Disorder Hypoglycemia

Focal neurologic deficits on 19 occasions in seven children with diabetes are reported from Children’s Hospital, Winnipeg, Manitoba, Canada. None had a history of a seizure disorder or a febrile seizure prior to onset of diabetes. One had generalized seizures attributed to hypoglycemia. Two had a parent with migraine. The neurological examination was normal between events, all of which occurred during sleep. All seven patients had at least one episode of a focal motor deficit. Two children had separate episodes of right and left-sided hemiparesis, two had focal motor seizures followed by ipsilateral paresis, and two had headache beginning after the onset of the acute neurologic event. Hypoglycemia was demonstrated on the three occasions that blood glucose was measured at the outset of hemiparesis or focal seizures. [1]

COMMENT. The authors consider that focal seizures induced by hypoglycemia are the most likely cause of these transient neurologic deficits and that the paretic episodes are examples of Todd paralysis. The administration of sugar did not always result in reversal of the neurologic deficit and the neurological symptoms were not a direct consequence of hypoglycemia. Hemiplegic migraine seemed to be an unlikely explanation. The anticonvulsant phenytoin has a hyperglycemic effect [2] and may be beneficial in the treatment of seizures and transient hemiparesis associated with hypoglycemia in diabetic children.

 Wayne EA Dean HJ Booth F Tenenbein M Focal neurologic deficits associated with hypoglycemia in children with diabetes J Pediatr 1990 Oct 117 4 575 7 10.1016/S0022-3476(05)80691-2 1698958 Belton NR Etheridge JE Jr Millichap JG Effects of convulsions and anticonvulsants on blood sugar in rabbits Epilepsia 1965 Sep 6 3 243 9 10.1111/j.1528-1157.1965.tb03792.x 5214266