Abstract
That hypoglycaemia can cause brain damage cannot be disputed. There is, however, controversy over the definition of hypoglycaemia in neonates and children and over its significance when asymptomatic. We have measured sensory evoked potentials and correlated them to blood glucose concentrations in 15 children aged one day to 15 years. Eleven were fasted during investigations for recurrent hypoglycaemia; two were studied during spontaneous hypoglycaemia and two had insulin provocation for the investigation of short stature. Serial brainstem evoked potentials (EPs) were measured in 10 and somatosensory EPs in five. A blood glucose level ≤2.5 mmol/l was recorded in nine children, eight of whom shewed abnormal changes in EPs; only four were symptomatic. Following restoration of the blood glucose level > 2.5 mmol/l EPs returned immediately to normal in six, but in two (both neonates) the EPs remained abnormal for one hour and two days respectively. The only subject with no change in EPs had hyperketonaemic hypoglycaemia. No change was recorded in serial EPs in the six children who maintained blood glucose levels > 2.5 mmol/l. We conclude: 1) EPs allow an objective measurement of neural function in relation to intermediary metabolism; 2) asymptomatic hypoglycaemia is associated with neurophysiological dysfunction; 3) more detailed studies will allow a functional definition of hypoglycaemia in different groups of neonates and children.
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Thhg, K., Eyre, J., Tarbit, M. et al. NEUROPHYSIOLOGICAL, DYSFUNCTION IN NEONATES AND CHILDREN WITH BLOOD GLUCOSE CONCENTRATIONS OF LESS THAN OR EQUAL TO 2.5 MMOL/L. Pediatr Res 22, 233 (1987). https://doi.org/10.1203/00006450-198708000-00120
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DOI: https://doi.org/10.1203/00006450-198708000-00120