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[Hypoglycemia caused by growth hormone deficiency. Two cases in children with cerebral paresis]
1Randers Centralsygehus, paediatrisk afdeling.
Insights
Growth hormone deficiency (GHD) in children with cerebral palsy can cause seizures and hypoglycemia. Growth hormone therapy resolved these symptoms, highlighting an underrecognized GHD presentation.
Area of Science:
- Pediatrics
- Endocrinology
- Neurology
Background:
- Growth hormone deficiency (GHD) is a known childhood disorder, often linked to perinatal events.
- Cerebral palsy (CP) is a common neurodevelopmental condition in children.
- Epilepsy-like seizures are a recognized complication in some neurological disorders.
Observation:
- Two boys with cerebral palsy, aged 3 and 6, experienced growth retardation and hypoglycemic seizures.
- Both children had a history of perinatal asphyxiation and presented with drug-resistant seizures.
- Diagnostic tests revealed growth hormone deficiency (GHD) as the underlying cause.
Findings:
- Provocative testing confirmed GHD in both children.
- Treatment with growth hormone therapy led to the resolution of hypoglycemic seizures.
- Children experienced normal growth following hormone replacement therapy.
Implications:
- This case series suggests that GHD-induced hypoglycemia may mimic epilepsy in children with cerebral palsy.
- Early diagnosis and treatment of GHD are crucial for managing seizures and promoting growth in affected children.
- Highlights the importance of considering endocrine disorders in children with unexplained seizures and neurological conditions.
Abstract:
Growth hormone deficiency (GHD) associated with and secondary to asphyxiating perinatal events is a well-established disorder of childhood. However, hypoglycaemic fits due to GHD in children with cerebral palsy simulating symptomatic epilepsy do not seem well-recognized in literature. Within one year we have encountered two boys with cerebral palsy, one aged three and the other six years, who exhibited growth retardation and hypoglycaemic episodes. Both had suffered perinatal asphyxiation. Both had seizures which did not respond properly to antiepileptic drugs. Provocative tests (sleep and clonidine) disclosed GHD. Following growth hormone therapy, fits and hypoglycaemic episodes disappeared, and the children resumed normal growth.