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Pediatric Hypoglycemia
Miral D. Jhaveri, MD; P. Ellen Grant, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Significant hypoglycemia
                • Plasma glucose level < 30-35 mg/dL in the 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. Bathla G et al: Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol. 35(5):833-40, 2014
                                            2. Yoon HJ et al: Devastating metabolic brain disorders of newborns and young infants. Radiographics. 34(5):1257-72, 2014
                                            3. Boardman JP et al: Hypoglycaemia and neonatal brain injury. Arch Dis Child Educ Pract Ed. 98(1):2-6, 2013
                                            4. Wong DS et al: Brain injury patterns in hypoglycemia in neonatal encephalopathy. AJNR Am J Neuroradiol. 34(7):1456-61, 2013
                                            5. 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
                                            6. Sinclair JC et al: Interventions for prevention of neonatal hyperglycemia in very low birth weight infants. Cochrane Database Syst Rev. (10):CD007615, 2011
                                            7. 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
                                            8. Burns CM et al: Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 122(1):65-74, 2008
                                            9. Per H et al: Neurologic sequelae of neonatal hypoglycemia in Kayseri, Turkey. J Child Neurol. 23(12):1406-12, 2008
                                            10. Tam EW et al: Occipital lobe injury and cortical visual outcomes after neonatal hypoglycemia. Pediatrics. 122(3):507-12, 2008
                                            11. Volpe JJ: Neurology of the Newborn. 5th ed. Philadelphia: Saunders, 2008
                                            12. Yalnizoglu D et al: Neurologic outcome in patients with MRI pattern of damage typical for neonatal hypoglycemia. Brain Dev. 29(5):285-92, 2007
                                            13. Kim SY et al: Neonatal hypoglycaemic encephalopathy: diffusion-weighted imaging and proton MR spectroscopy. Pediatr Radiol. 36(2):144-8, 2006
                                            14. 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
                                            15. Vannucci RC et al: Hypoglycemic brain injury. Semin Neonatol. 6(2):147-55, 2001
                                            16. Cornblath M et al: Hypoglycemia in the neonate. Semin Perinatol. 24(2):136-49, 2000
                                            17. Hawdon JM et al: Clinical features of neonates with hyperinsulinism. N Engl J Med. 341(9):701-2, 1999
                                            18. 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

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Significant hypoglycemia
                                                          • Plasma glucose level < 30-35 mg/dL in the 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. Bathla G et al: Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol. 35(5):833-40, 2014
                                                                                      2. Yoon HJ et al: Devastating metabolic brain disorders of newborns and young infants. Radiographics. 34(5):1257-72, 2014
                                                                                      3. Boardman JP et al: Hypoglycaemia and neonatal brain injury. Arch Dis Child Educ Pract Ed. 98(1):2-6, 2013
                                                                                      4. Wong DS et al: Brain injury patterns in hypoglycemia in neonatal encephalopathy. AJNR Am J Neuroradiol. 34(7):1456-61, 2013
                                                                                      5. 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
                                                                                      6. Sinclair JC et al: Interventions for prevention of neonatal hyperglycemia in very low birth weight infants. Cochrane Database Syst Rev. (10):CD007615, 2011
                                                                                      7. 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
                                                                                      8. Burns CM et al: Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 122(1):65-74, 2008
                                                                                      9. Per H et al: Neurologic sequelae of neonatal hypoglycemia in Kayseri, Turkey. J Child Neurol. 23(12):1406-12, 2008
                                                                                      10. Tam EW et al: Occipital lobe injury and cortical visual outcomes after neonatal hypoglycemia. Pediatrics. 122(3):507-12, 2008
                                                                                      11. Volpe JJ: Neurology of the Newborn. 5th ed. Philadelphia: Saunders, 2008
                                                                                      12. Yalnizoglu D et al: Neurologic outcome in patients with MRI pattern of damage typical for neonatal hypoglycemia. Brain Dev. 29(5):285-92, 2007
                                                                                      13. Kim SY et al: Neonatal hypoglycaemic encephalopathy: diffusion-weighted imaging and proton MR spectroscopy. Pediatr Radiol. 36(2):144-8, 2006
                                                                                      14. 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
                                                                                      15. Vannucci RC et al: Hypoglycemic brain injury. Semin Neonatol. 6(2):147-55, 2001
                                                                                      16. Cornblath M et al: Hypoglycemia in the neonate. Semin Perinatol. 24(2):136-49, 2000
                                                                                      17. Hawdon JM et al: Clinical features of neonates with hyperinsulinism. N Engl J Med. 341(9):701-2, 1999
                                                                                      18. Barkovich AJ et al: Imaging patterns of neonatal hypoglycemia. AJNR Am J Neuroradiol. 19(3):523-8, 1998