Abstract
Recurrent hypoglycemia (H) may lead to cortical brain injury by altering both neurological development and intelectual funtion. Sixtyseven children aged 0-14 year-range suffering H from different etiologies (except transient H of newborn) were evaluated. Six patients died after diagnosis; 18 did not come for follow-up. Out of 43 patients studied, 13 had ketotic H,9 had hiperinsulinism, 16 had H due to enzymatic defects, 3 to hypopituitarism and 2 of unknown cause. Neurological examination and KEg were performed at 3-94 months after diagnosis. Cognitive level of children under 2 years (n:8) was determined with the Bayley Scale of Child Development (IDM), values above 68 were considered normal. Terman-Merrill test was used to measure IQ in children over 2 years; values below G9 were considered as mental retardation; the range 69-80 was taken as borderline. Neurological sequelae were: secondary epilepsy (4), cerebral palsy (1), and microcephaly (2).
Mean IQ of the sample was 87.5 (S.D.18). Mental retardation was present in 8 (18%). IQ 80 was significantly more prevalent in both hyperinsulinism and glycogenosis III than in the ketotic group. The mean delay in achiving the diagnosis was 16 (S.D.19) months; being the longer the delay the lower the IQ (r:-0.54). IQ below 80 was also more prevalent in those who had had seizures. Etiology, delay of diagnosis and treatment, presence of seizures and asintomatic H, like in glycogenosis III are important factors determining the outcome.
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Bay, L., Ranzoni, G., Contreras, M. et al. COGNITIVE AND NEUROLOGICAL EVALUATION IN THE FOLLOW-UP OF CHILDREN WITH HYPOGLYCEMIA OF DIFFERENT ETIOLOGIES.. Pediatr Res 33, 659 (1993). https://doi.org/10.1203/00006450-199306000-00026
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DOI: https://doi.org/10.1203/00006450-199306000-00026