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Hypoglycemia
Kevin R. Moore, MDMiral D. Jhaveri, MD, MBAP. Ellen Grant, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Neonate with significant hypoglycemia
                  • Plasma glucose level < 30-35 mg/dL in first 24 hours of life
                  • < 40-45 mg/dL (after 24 hours)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          • Prevention

                                            DIAGNOSTIC CHECKLIST

                                            • Reporting Tips

                                              Selected References

                                              1. Arhan E et al: Neonatal hypoglycemia: a wide range of electroclinical manifestations and seizure outcomes. Eur J Paediatr Neurol. 21(5):738-44, 2017
                                              2. De Leon DD et al: Congenital hypoglycemia disorders: new aspects of etiology, diagnosis, treatment and outcomes: highlights of the proceedings of the congenital hypoglycemia disorders symposium, Philadelphia April 2016. Pediatr Diabetes. 18(1):3-9, 2017
                                              3. Goode RH et al: Developmental outcomes of preterm infants with neonatal hypoglycemia. Pediatrics. 138(6), 2016
                                              4. Bathla G et al: Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol. 35(5):833-40, 2014
                                              5. Yoon HJ et al: Devastating metabolic brain disorders of newborns and young infants. Radiographics. 34(5):1257-72, 2014
                                              6. Boardman JP et al: Hypoglycaemia and neonatal brain injury. Arch Dis Child Educ Pract Ed. 98(1):2-6, 2013
                                              7. Wong DS et al: Brain injury patterns in hypoglycemia in neonatal encephalopathy. AJNR Am J Neuroradiol. 34(7):1456-61, 2013
                                              8. Tam EW et al: Hypoglycemia is associated with increased risk for brain injury and adverse neurodevelopmental outcome in neonates at risk for encephalopathy. J Pediatr. 161(1):88-93, 2012
                                              9. Sinclair JC et al: Interventions for prevention of neonatal hyperglycemia in very low birth weight infants. Cochrane Database Syst Rev. (10):CD007615, 2011
                                              10. Musson RE et al: Diffusion-weighted imaging and magnetic resonance spectroscopy findings in a case of neonatal hypoglycaemia. Dev Med Child Neurol. 51(8):653-4, 2009
                                              11. Burns CM et al: Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 122(1):65-74, 2008
                                              12. Per H et al: Neurologic sequelae of neonatal hypoglycemia in Kayseri, Turkey. J Child Neurol. 23(12):1406-12, 2008
                                              13. Tam EW et al: Occipital lobe injury and cortical visual outcomes after neonatal hypoglycemia. Pediatrics. 122(3):507-12, 2008
                                              14. Volpe JJ: Neurology of the Newborn. 5th ed. Philadelphia: Saunders, 2008
                                              15. Yalnizoglu D et al: Neurologic outcome in patients with MRI pattern of damage typical for neonatal hypoglycemia. Brain Dev. 29(5):285-92, 2007
                                              16. Kim SY et al: Neonatal hypoglycaemic encephalopathy: diffusion-weighted imaging and proton MR spectroscopy. Pediatr Radiol. 36(2):144-8, 2006
                                              17. Alkalay AL et al: Brain imaging findings in neonatal hypoglycemia: case report and review of 23 cases. Clin Pediatr (Phila). 44(9):783-90, 2005
                                              18. Vannucci RC et al: Hypoglycemic brain injury. Semin Neonatol. 6(2):147-55, 2001
                                              19. Cornblath M et al: Hypoglycemia in the neonate. Semin Perinatol. 24(2):136-49, 2000
                                              20. Hawdon JM et al: Clinical features of neonates with hyperinsulinism. N Engl J Med. 341(9):701-2, 1999
                                              21. Barkovich AJ et al: Imaging patterns of neonatal hypoglycemia. AJNR Am J Neuroradiol. 19(3):523-8, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Neonate with significant hypoglycemia
                                                              • Plasma glucose level < 30-35 mg/dL in first 24 hours of life
                                                              • < 40-45 mg/dL (after 24 hours)

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      • Prevention

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Arhan E et al: Neonatal hypoglycemia: a wide range of electroclinical manifestations and seizure outcomes. Eur J Paediatr Neurol. 21(5):738-44, 2017
                                                                                          2. De Leon DD et al: Congenital hypoglycemia disorders: new aspects of etiology, diagnosis, treatment and outcomes: highlights of the proceedings of the congenital hypoglycemia disorders symposium, Philadelphia April 2016. Pediatr Diabetes. 18(1):3-9, 2017
                                                                                          3. Goode RH et al: Developmental outcomes of preterm infants with neonatal hypoglycemia. Pediatrics. 138(6), 2016
                                                                                          4. Bathla G et al: Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol. 35(5):833-40, 2014
                                                                                          5. Yoon HJ et al: Devastating metabolic brain disorders of newborns and young infants. Radiographics. 34(5):1257-72, 2014
                                                                                          6. Boardman JP et al: Hypoglycaemia and neonatal brain injury. Arch Dis Child Educ Pract Ed. 98(1):2-6, 2013
                                                                                          7. Wong DS et al: Brain injury patterns in hypoglycemia in neonatal encephalopathy. AJNR Am J Neuroradiol. 34(7):1456-61, 2013
                                                                                          8. Tam EW et al: Hypoglycemia is associated with increased risk for brain injury and adverse neurodevelopmental outcome in neonates at risk for encephalopathy. J Pediatr. 161(1):88-93, 2012
                                                                                          9. Sinclair JC et al: Interventions for prevention of neonatal hyperglycemia in very low birth weight infants. Cochrane Database Syst Rev. (10):CD007615, 2011
                                                                                          10. Musson RE et al: Diffusion-weighted imaging and magnetic resonance spectroscopy findings in a case of neonatal hypoglycaemia. Dev Med Child Neurol. 51(8):653-4, 2009
                                                                                          11. Burns CM et al: Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 122(1):65-74, 2008
                                                                                          12. Per H et al: Neurologic sequelae of neonatal hypoglycemia in Kayseri, Turkey. J Child Neurol. 23(12):1406-12, 2008
                                                                                          13. Tam EW et al: Occipital lobe injury and cortical visual outcomes after neonatal hypoglycemia. Pediatrics. 122(3):507-12, 2008
                                                                                          14. Volpe JJ: Neurology of the Newborn. 5th ed. Philadelphia: Saunders, 2008
                                                                                          15. Yalnizoglu D et al: Neurologic outcome in patients with MRI pattern of damage typical for neonatal hypoglycemia. Brain Dev. 29(5):285-92, 2007
                                                                                          16. Kim SY et al: Neonatal hypoglycaemic encephalopathy: diffusion-weighted imaging and proton MR spectroscopy. Pediatr Radiol. 36(2):144-8, 2006
                                                                                          17. Alkalay AL et al: Brain imaging findings in neonatal hypoglycemia: case report and review of 23 cases. Clin Pediatr (Phila). 44(9):783-90, 2005
                                                                                          18. Vannucci RC et al: Hypoglycemic brain injury. Semin Neonatol. 6(2):147-55, 2001
                                                                                          19. Cornblath M et al: Hypoglycemia in the neonate. Semin Perinatol. 24(2):136-49, 2000
                                                                                          20. Hawdon JM et al: Clinical features of neonates with hyperinsulinism. N Engl J Med. 341(9):701-2, 1999
                                                                                          21. Barkovich AJ et al: Imaging patterns of neonatal hypoglycemia. AJNR Am J Neuroradiol. 19(3):523-8, 1998