Hypoglycemia vs. Epilepsy: Recognizing the Etiology of Seizure Episodes and Loss of Consciousness

In clinical practice, loss of consciousness and seizure episodes are symptoms that can have multiple etiologies, with hypoglycemia and epilepsy being two of the most common causes. Recognizing the difference between these conditions is crucial for appropriate and timely management. This article explores the distinctive characteristics of each and offers guidelines for differential diagnosis.

Diving into the Etiology of Seizure Episodes

Hypoglycemia, defined as low blood glucose levels, can provoke neurological symptoms that include confusion, behavioral changes, and, in severe cases, seizures. It is essential to measure glucose levels with a glucometer in patients presenting with seizure episodes, especially if they have a history of diabetes or metabolic risk factors. A study on neonates with hypoglycemia showed that this condition can lead to intractable epilepsy, underscoring the importance of early and accurate diagnosis.

On the other hand, epilepsy is a neurological disorder characterized by the recurrence of unprovoked seizure episodes. The causes can be diverse, ranging from structural brain abnormalities to metabolic disorders. In patients with epilepsy, seizures can be focal or generalized, and the diagnosis relies on clinical history, neurological examination, and studies such as EEG.

An interesting aspect is the use of the ketogenic diet as a treatment for refractory epilepsy, especially in cases associated with neonatal hypoglycemia. This diet, high in fats and low in carbohydrates, has shown effectiveness in reducing the frequency of seizures in some patients.

Conclusions

Differentiating between hypoglycemia and epilepsy as causes of seizure episodes is essential for appropriate treatment. Measuring blood glucose is a critical initial step in the evaluation of patients with loss of consciousness and seizures. Additionally, recognizing specific patterns in EEG and obtaining a detailed clinical history are valuable tools for the diagnosis of epilepsy. The implementation of treatments such as the ketogenic diet can offer significant benefits in selected cases. Understanding these conditions and their proper management can significantly improve clinical outcomes and the quality of life for patients.

Referencias

• [1] Neonatal hypoglycemia: A wide range of electroclinical manifestations and seizure outcomes.
• [2] Seizures and epilepsy in cancer: etiologies, evaluation, and management.
• [3] A case series of the efficacy and tolerability of ketogenic diet in children with drug-resistant epilepsy due to neonatal hypoglycemia.

Created 6/1/2025