Variable outcome for epilepsy after neonatal hypoglycaemia

Fong, Choong Yi; Harvey, A. Simon

doi:10.1111/dmcn.12496

Cited by 32 publications

(31 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Severe and prolonged hypoglycemia can result in mental retardation, neurological deficits, and recurrent seizures. 19,20 Management of hypoglycemia according to World Health organization (WHO) guidelines 11 includes rapid administration of exogenous glucose, preferably through an intravenous access. In the developing world, hypoglycemia remains an insufficiently recognized killer of children, as it is seldom diagnosed and whenever detected, often poorly managed mainly because of the lack of simple equipment or trained staff.…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Madrid¹,

Acácio²,

Nhampossa³

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Hypoglycemia is a life-threatening complication of several diseases in childhood. We describe the prevalence and incidence of hypoglycemia among admitted Mozambican children, establishing its associated risk factors. We retrospectively reviewed clinical data of 13 years collected through an ongoing systematic morbidity surveillance in Manhiça District Hospital in rural Mozambique. Logistic regression was used to identify risk factors for hypoglycemia and death. Minimum community-based incidence rates (MCBIRs) for hypoglycemia were calculated using data from the demographic surveillance system. Of 49,089 children < 15 years hospitalized in Manhiça District Hospital, 45,573 (92.8%) had a glycemia assessment on admission. A total of 1,478 children (3.2%) presented hypoglycemia (< 3 mmol/L), of which about two-thirds (972) were with levels < 2.5 mmol/L. Independent risk factors for hypoglycemia on admission and death among hypoglycemic children included prostration, unconsciousness, edema, malnutrition, and bacteremia. Hypoglycemic children were significantly more likely to die (odds ratio [OR] = 7.11; P < 0.001), with an associated case fatality rate (CFR) of 19.3% (245/1,267). Overall MCBIR of hypoglycemia was 1.57 episodes/1,000 child years at risk (CYAR), significantly decreasing throughout the study period. Newborns showed the highest incidences (9.47 episodes/1,000 CYAR, P < 0.001). Hypoglycemia remains a hazardous condition for African children. Symptoms and signs associated to hypoglycemia should trigger the verification of glycemia and the implementation of life-saving corrective measures.

show abstract

Section: Introductionmentioning

confidence: 99%

Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique

Madrid¹,

Acácio²,

Nhampossa³

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…These infants have increased glucose requirements and go on having problems with hypoglycemia longer than those hypoglycemic babies who are not hyperinsulinemic [1]. Early identification, prevention and treatment of hypoglycemia in patients with defects in certain metabolic pathways or in the regulation of insulin secretion are important for long-term outcomes [12]. The initial treatment for hypoglycemia is with glucose and sometimes with steroids.…”

Section: Discussionmentioning

confidence: 99%

Experience of Octreotide Therapy for Hyperinsulinemic Hypoglycemia in Neonates Born Small for Gestational Age: A Case Series

Pan¹,

Zhang²,

Li³

2015

Horm Res Paediatr

View full text Add to dashboard Cite

Aims: Hyperinsulinemic hypoglycemia (HH) is common in small-for-gestational-age (SGA) neonates. Diazoxide is often used as the first-line medication for HH in SGA neonates. Unfortunately, diazoxide is not authorized in China. We examined the effectiveness of octreotide as an alternative therapy to treat HH in SGA neonates. There is limited data on the use of octreotide in HH of SGA neonates. Methods: Seven SGA neonates with HH who were admitted to the Department of Neonatology at the Third Affiliated Hospital of Sun Yat-sen University between January 2013 and December 2014 received octreotide at an initial dose of 5 μg/kg/day through subcutaneous injection at 8-hour intervals. Depending on the glycemic control, the dose of octreotide was increased in increments of 2-5 μg/kg/day every 3-5 days to the maximum dose of 30 μg/kg/day. Results: The age of neonates with HH diagnosis ranged from 1 to 4 days. The maximum dose of octreotide ranged from 8 to 18 μg/kg/day. The duration of octreotide therapy ranged from 9 to 45 days. All patients had a clear glycemic response to octreotide, and no major adverse events were observed during the treatment. Conclusions: Octreotide may be a useful alternative therapy in HH of SGA neonates when diazoxide is unavailable.

show abstract

“…Current literature describing the clinical features of epilepsy following neonatal hypoglycaemia consists of small retrospective case series from tertiary centres and the study by Fong and Harvey falls within that category. However, its strengths include the detailed description of the electroclinical features, including associated intellectual, motor, and sensory impairments.…”

mentioning

confidence: 99%