Abnormal electroencephalogram at diagnosis of insulin-dependent diabetes mellitus may predict severe symptoms of hypoglycemia in children

• Published in: The Journal of pediatrics 1998-12, Vol.133 (6), p.792-794
• Main Authors: Tupola, Sarimari, Saar, Pekka, Rajantie, Jukka
• Format: Article
• Language: English
• Subjects: Adolescent; Anatomy; Associated diseases and complications; Biological and medical sciences; Child; Child, Preschool; Control Groups; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes. Impaired glucose tolerance; Electroencephalography; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Hospitals; Humans; Hypoglycemia - diagnosis; Infant; Interviews; Medical sciences; Neurological Impairments; Patients; Predictive Value of Tests
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(98)70154-4

Objectives: To evaluate the predictive value of the electroencephalogram (EEG) at the time of diagnosis of insulin-dependent diabetes mellitus (IDDM) for subsequent hypoglycemic coma and/or convulsion. To study whether such an episode causes long-term EEG abnormalities. Study design: An EEG was recorded in 36 patients with IDDM 2 to 3 weeks after diagnosis (median age, 7.5 years) and was then repeated after an episode of severe hypoglycemia associated with coma and/or convulsion (median age, 13.3 years). Paired EEGs were also recorded in 36 age-matched and IDDM duration–matched control patients who had never experienced severe hypoglycemia. A single EEG was recorded in 36 healthy children, matched with patients’ ages at the time of IDDM diagnosis. Results: Patients with severe hypoglycemia had an abnormal initial EEG recording more often than did control patients with IDDM (22.2% vs 2.8%, P = .03). Each of the healthy children had a normal EEG recording. The odds ratio for risk of subsequent coma and/or convulsion during hypoglycemia in patients with abnormal initial EEG recordings was 8 (95% CI, 1.1-354.7). After such an episode, the frequency of the abnormal EEG recordings was not elevated. Conclusions: EEG at the time of diagnosis of IDDM may be useful in identifying those patients at increased risk for coma and/or convulsion as a result of hypoglycemia. However, a single such episode did not appear to have a deleterious effect on the subsequent EEG. (J Pediatr 1998;133:792-4)