Association of Spontaneous Hypoglycemia With Hypocalcemia and Electrocerebral Dysfunction

Neurological Changes in Hypoglycemia

“…The first studies aimed to see whether cognitive dysfunction was mirrored by altered EEG activity during hypoglycemia date back to more than 60 years ago. Specifically, abnormal EEG activity defined as slow potentials was observed in ref 5 and distorted EEG waves with higher amplitude during hypoglycemia were reported in ref. 6 In the past decades, the increase in the power of low frequency bands, that is, delta and theta frequency range, during hypoglycemia in T1D patients was assessed in many studies in the literature.…”

Pseudohypoglycemic Reactions in Insulin‐treated Diabetics: Etiology, Laboratory Aids and Therapy*

“…The similarity of the clinical manifestations of hypocalcemia and hypoglycemia is well known (14). We have previously reported (8) pseudohypoglycemic reactions in the form of muscle twitches, convulsions and loss of consciousness in a 14‐year‐old diabetic girl with hypocalcemia, and the disappearance of these symptoms after correction of the hypocalcemic state.…”

“…Since many of the manifestations of parathyroid insufficiency and hypocalcemia may mimic those of hypoglycemia (14), serum calcium determinations were made routinely in all subjects. Tests commonly used in the diagnosis of thyrotoxicosis and pheochromocytoma were carried out in patients whose clinical symptoms suggested the possibility of these illnesses.…”

“…For these reasons we have proposed the term “pseudohypoglycemic reaction” to designate the clinical symptoms that resemble those of an insulin reaction (in both labile and stable diabetes) but develop in the absence of a critically low blood sugar level (6–8). The occurrence of pseudohypoglycemic reactions was later reported in association with: (a) clinical disorders which can interfere with the normal function of the central nervous system, e.g., cerebral arteriosclerosis, and (b) clinical disorders accompanied by symptoms similar to those of hypoglycemia, e.g., the hypocalcemia of hypoparathyroidism (6, 11–16).…”

Detection of Hypoglycemia Using Measures of EEG Complexity in Type 1 Diabetes Patients

“…In the 1940s, it was observed that abnormal EEG activity (characterized by an increase of delta and theta activity and irregular or disorganized patterns) occurs during hypoglycemia. Later, researchers emphasized the importance of BG concentration on cerebral function, observing EEG dysrhythmia (i.e., distorted EEG waves with higher amplitude) during hypoglycemia [ 8 , 9 ]. Moreover, there is some evidence showing that power in low-frequency EEG bands (<8 Hz) increases during hypoglycemia [ 10 , 11 ], while a decrease in EEG scalp connectivity was seen in the path from the occipital lobes to the temporal and central lobes during hypoglycemia in the theta (O1→C4, O2→Cz, T5→C3) and alpha (O1→T4, O1→C4) bands by computing the directional effect of one EEG recording channel over another through the information partial directed coherence function [ 12 , 13 , 14 ].…”