Hyperglycemia Lowers Seizure Threshold

[RobinN]

The important new finding from Schwechter and colleagues is that hyperglycemia, itself, is proconvulsant. How can elevated glucose enhance seizure susceptibility? The answer to this crucial question regarding the mechanism of action awaits further research, as the mechanism per se is not addressed in this report. However, one clue to the answer might be gleaned from the authors's observation that hypoglycemia was associated with a higher seizure threshold. Other studies have indicated that restricting calories, thus inducing hypoglycemia, in the epilepsy-prone EL mouse also reduces seizure susceptibility (2). With any model that induces hypoglycemia, the role of ketosis must be excluded, as ketones themselves can affect seizure threshold (3). Moreover, multiple other mechanisms could explain hypoglycemia- and hyperglycemia-induced alterations of neuronal excitability. Furthermore, the effects of age on glucose balance and neuronal excitability must be delineated, as children with diabetes tend to develop seizures with hypoglycemia rather than with hyperglycemia. In addition to clarifying further the relation between hyperglycemia and seizures, Schwechter et al. highlight the link between metabolism and neuronal excitability and emphasize the need for further research on the long-term effects of hyperglycemia on various aspects of brain function.

http://www.pubmedcentral.nih.gov/art...i?artid=387262

[Nakamova]

I have the opposite experience -- for me, low blood sugar (hypoglycemia) is a seizure trigger, it lowers my seizure threshold....

[RobinN]

Yes I am doing some research on this, as the same seems to be true for my daughter as well.

Her blood sugar is dropping before a seizure and then sometime spiking after.
Though her last seizure when 911 was called it went down to 30. So we had a glucose tolerance test and it was at 50 on the last blood draw.

I am reading conflicting information. Which only proves to me that they don't know much about this or why it really occurs.

Can you tell me what you have done to try to remedy your situation. How do you manage it?
Have you made nutritional changes?

[drarvindr]

that hypOglycemia causes seizures seems to be more of an established occurrance than hyperglycemia. i live in a country with the world's largest burden of type 2 diabetes. virtually every indian male above 40 is at risk for diabetes. but i haven't seen their seizure frequency increase dramatically. the few diabetics i have seen with seizures was when they took too much insulin or forgot to eat and became hypoglycemic. it is an interesting article , but the findings are pretty much inconclusive . i'm not sure if they are reliable enough to recommend dietary interventions.

[RobinN]

(HealthDay News) — Hypoglycemia, the medical term for low blood sugar, is a common complication among people with diabetes.

The American Diabetes Association offers this list of warning signs and treatments for hypoglycemia:

* Symptoms may include dizziness, shakiness, sweating, headache, hunger, pale skin, sudden mood change, tingling around the mouth, and confusion.
* Treat hypoglycemia as soon as you notice symptoms. The condition can quickly become an emergency without treatment, if blood sugar drops dangerously low.
* Eat some sort of sugar, such as a few pieces of hard candy, 1/2 cup of fruit juice, or glucose tablets.
* Have a glucagon (a medication that quickly raises blood sugar) syringe on hand. In the event that you pass out, make sure friends and family know how to immediately use the shot. This is a medical emergency, and in addition to getting the shot, you should receive emergency care.

http://www.medicinenet.com/script/ma...ticlekey=90282

Seems to me these symptoms are going to hit someone fairly strong if one is prone to seizures.

[RobinN]

i live in a country with the world's largest burden of type 2 diabetes. virtually every indian male above 40 is at risk for diabetes.

Can you explain why this is happening?

[RobinN]

Of all the organs in the body, the brain depends on sugar (which we are now going to refer to as glucose) almost exclusively. Rarely, if absolutely necessary, the brain will use ketones as a fuel source, but this is not preferred. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason, the glucose level in the blood falls (or if the brain's requirements increase and demands are not met) there can be effects on the function of the brain.

http://www.medicinenet.com/hypoglycemia/article.htm

I don't think enough is known about blood sugar levels and why we are seeing an increase in the disregulation of it.

[drarvindr]

It is difficult to say. our genetics predispose a vast majority of us to diabetes and hypertension. since type 2 diabetes is largely genetic in its pathogenesis , it means that we are at an enormous risk when diabetes is concerned. Foreign doctors i have met all jokingly told me that it is unnecessary to ask family history of diabetes in indians because they all have it , along with hypertension. my dad is hypertensive and diabetic. my mom is hypertensive. Our eating habits and cultural practices are insufficient pointers toward diabetes , since these vary from on region in india to the next , while the burden of diabetes seems spread evenly.
India is set to become the "diabetes capital" of the world by 2020.Not happy figures.

[ziggidypoo]

IMHO - from one who has both Diabetes II and Epilepsy - from what I can remember from the ole college days - (as stated above) the brain must have a certain amt of sugar in order to function and the rest of the body cannot function w/o the brain - so, perhaps an overload of sugar in the body (hyperglycemia or high blood sugar) can cause the brain to OVER electrify??? Too low, using this same theory should cause coma!! ALTHOUGH, if I remember correctly, if the body is in a state of starvation which the brain could think it is in hypoglycemia, can't it convert the body's fat storage into sugar??? Just thinking outloud. I do know that over all when I've had my insulin (just back on it in the last couple mos) and my blood sugar is below 200, I feel energetic and feel terrific and have great attitude. High or low can cause behavior changes (temporal lobe??). I do know that obesity increases the possibility for hyperglycemia - eat more?? Genetics too. My natural father who I really did not know much of and only lived 4 yrs with, and my first child who I never lived with, and my son who I mostly raised, and my Native American Indian tribe all were/and/or are built like me - tall, huge bones, big all over - not a pot belly or any one area - all over, and even had/have huge feet (I wear a size 12 woman's shoe as does the daughter I did not raise - she was skinny when I first met her when she was 18, but after her child was born she gained up to over 300# and she and my grandchild are both diabetics with epilepsy!! My son wears a size 16 shoe. ) My middle child fights wgt problems and after her child was born put on wgt and recent photos show some wgt gain, no diabetes yet. My son has hypOglycemia (how I started) now at 24, hypertensive since he was 10 or 11 yrs old. My daughter in the middle (3 kids) is soon to be a nurse and where she works requires medical check-ups, psychotherapy, I think has a gym, etc.

Who knows anything for sure - just tossing out thoughts and experiences in my life.

Glad this topic was brought up. Thanks for listening to my ramblings. Gail

[Cint]

I also have Diabetes, Type 1, along with epilepsy. But I developed diabetes as an adult, even though it is Type 1. I have to take insulin shots 5 times a day and really watch my diet to control my glucose. The other morning, I woke around 4:00, feeling strange, shaking, and knew to check my glucose. It was down to 37. OMG!! Had to get something in my stomach ASAP!! So far, I haven't had a diabetic seizure, and hope I never will, but who knows. Now my endocrinologist wants me to take a cholesterol med, along with all my seizure meds, anti-depressants, (which, by the way is why I ended up with diabetes in the first place), insulin, blood pressure med, thyroid meds. But I'm afraid to take it because the side effects listed are seizures! My neurologist and endo are both telling me it is ok to take this medication, but my instinct is telling me NO! We're still having problem getting my A1c down below 7, although I am exercising, watching my diet, etc. IMO, I think these meds interacting have something to do with it, but my doctors don't want to hear that. They just want to prescribe more drugs!

Ok, I'll be quiet now. I was starting to get on my soapbox, again!

Cindy

[ziggidypoo]

After quitting smoking - EVERY TIME WITHOUT FAIL - I gain 50#. Thus, sugar up, thus, can't walk right now except in room. Change in metabolism???

Anyway, today, I started counting up the things right: quit smoking; not peeing the bed (diabetes related); not having to have sliding scale regular humulin insulin now the other insulin in the morning and pills are covering well; not staying in bed all day (quite the opposite); lungs 95% better except the sleep apnea; able to walk to and from bathroom; able to shower myself for the most part; able to roll over in bed; etc. - all these things I at one time could not do and worse!!! Today, cutting meals in 1/2 (against Carey's will) and told him for snack instead of red meat/liver, let's go for ground turkey (also cheap). I do eat my breakfast - BREAK the FAST of the night. I gave Carey my cake at lunchtime for dessert. So, all of these things will help. Also, he is supposed to remind me to TRY to walk as far up the walkway as I can until my back screams then back again - that's how I started walking to begin with after I had been 5 yrs in a wheelchair. Only back then it was try to walk with the walker to the bathroom and then back!!!!

What's this got to do with epilepsy - I am wondering if obesity which seems to cause EVERYTHING can have any influence on it.

Also, Type I diabetes I thought was juvenile; and type II was adult onset??

Please inform the ignorant.

I WAS on 2 shots in the a.m./ 1 @ noon/ 2 @ 5p.m./ and 1 @ 8 p.m. and my sugar was just under 500 and no matter how much insulin - it would not come down and my organs were all being affected and could not walk/situp/ or anything - I was 500# then. I'm about 425-450# now - not sure. BUT, in TN, 10 yrs ago this month I was just given up on. HERE, in Miami, we are doing everything possible to keep me alive and kickin'.

Quitting smoking after smoking off and on since I was younger than my son who is 24 and smoking 2 pks day was the biggest thing - over 2 mos now - almost dying from pulmonary attack/almost arrest helped with the option.

Epilepsy? It doesn't seem to bother me - just everyone in my family and all who see it and all who deal with my memory loss. I just go with the flow of it. The only thing that bugs me about it is going to the ER - that - no no no nono - only if it is one attack after another and another and / or a SUPER long post-ictal time prior to the long "sleep it off" time.

Well, I'm done - my -box derby run!!

[RobinN]

Abstract

Objective: Diabetic nephropathy is the leading cause of death in diabetics in Pakistan. Various environmental factors are involved in the pathophysiology of the complications of diabetes. Cigarette smoking is foremost among the environmental factors that contributes to the progression of diabetic nephropathy; however, sufficient data on the effect of smoking on the decline in kidney function in diabetic nephropathy are lacking. We assessed the impact of smoking on the progression of diabetic nephropathy in patients with type 1 diabetes. Methodology: A total of 120 diabetic patients with nephropathy (aged between 25 and 75 years) admitted in the diabetic wards of Jinnah Postgraduate Medical Center (JPMC) and Civil Hospital Karachi (CHK), Karachi, were selected for the present study after informed consent was obtained. They were divided into two groups: smokers and non-smokers. Fifty age-matched normal individuals with no known history of smoking, hyperglycemia, and/or renal insufficiency were selected as control. Their height (in meters) and weight (in kilograms) were recorded for calculation of body mass index. Their blood pressures were measured using a standard mercury sphygmomanometer. Fasting blood samples were collected and analyzed for blood glucose, serum sialic acid, urea and creatinine; serum cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol were measured by spectrophotometric techniques. Glomerular filtration rate (GFR) was calculated. HbA 1c was measured by fast ion-exchange resin separation method. Results: Compared with non-smokers, smokers had significantly higher values of blood pressure, blood glucose, HbA 1c , serum sialic acid, urea, creatinine, cholesterol, LDL-cholesterol and triglyceride. GFR and HDL-cholesterol values were lower in smokers than in nonsmokers. More obese (on the basis of BMI) patients were found among the smokers as compared to nonsmokers. Conclusion: Smoking is strongly associated with hyperglycemia, dyslipidemia, and decline in GFR, leading to progression of end-stage renal disease in diabetes. Further long-term studies are required to clarify the exact mechanism by which smoking causes decline in renal function.
http://www.ijddc.com/article.asp?iss...;aulast=Shahid

[Cint]

Also, Type I diabetes I thought was juvenile; and type II was adult onset??

Please inform the ignorant.

Usually Type 1 diabetes is juvenile and Type II is adult onset, but mine was brought on by an anti-psychotic drug prescribed for bi-polar disorder. Within 6 months of taking that drug, I had started losing weight, experienced blurred vision, was very, very tired, all the classical symptoms of Type 1 Diabetes. Zyprexa is the name of the drug. Be careful of what you swallow!!

That is why I'm reluctant to take another drug that has seizures listed as a side effect and the doctors say "don't worry." Yeah, right. That's what the shrink said about Zyprexa.
But I'm trusting my inner voice this time.

[alivenwell]

Could any of the fatigue be resolved with an air/oxygen mask (c.p.a.p.) worn at bedtime? I recall being somewhere where I was starting to feel sleepy. Within a few hours, other people had the same symptoms. It was caused by a low oxygen level.

I personally had a sleep study done. Normally, I am very tired in the morning. I slept with the cpap and woke up at the highly unusual hour of 5am very refreshed. That device was not drug invasive, but extremely helpful.

[skillefer]

hi Robinn! I have hypoglycemia as well as seizures. My grandfather had diabetes (Type 2), and was insulin dependent by the time he passed away. When I was growing up, I noticed that about 30 minutes after eating alot of rice or potatoes or other starches or sweets, my mother would fall asleep on the couch. When I noticed that my hands trembled when I was hungry and asked my GP why, he said it was because I needed to eat. But didn't go into any details....so I figured that meant eat whatever I wanted...and heck, I have a sweet tooth. One day, I had a seizure while driving. Luckily nobody was hurt. When I woke up, the paramedics were checking my blood sugar and insisted that I go see a doctor. I went and had lunch, and then went to the doctor's and had my blood sugar level tested. 2 hours after eating, my blood sugar was at 60. 60 is low enough to trigger seizures in other people. My doc asked about my family history, and smiled when I told her about my grandpa and mom. She explained that what I had was hypoglycemia, and that it is a precursor to diabetes. If I can get control of my blood sugar now, there's a good chance that I can either slow or stop the progression to diabetes. She told me that I had to have protein at all my meals, and to avoid foods made with sugar if I could. She said that the old candy or juice trick for when my blood sugar drops should be immediately followed with either cheese or nuts to slow the sugar absorption and to make sure that my blood sugar didn't spike and then drop again too suddenly.

[RobinN]

Thank you so much for that information.
That is a good summary of where I need to be headed.
My instincts from day one have been right.
There has to also be a connection between the health of the liver pathways, and also intestinal absorption.

Now... to figure out nutritionally if giving her casein is worth the chance, or if meat and nuts are the best alternatives.

[ziggidypoo]

Sleep Apnea is dangerous because you stop breathing for short periods of time in your sleep and it can cause multiple long-term problems in all body systems. It can also cause you to fall asleep at all times of the day - including while driving on the road!! The CPAP machine provides a constant air-flow pressurized so that if you stop breathing it forces air into the lungs during the "Gap".

Get this my blood sugar was 100 at 4 p.m. -

I've cut meals in 1/2; no pasta; extra veggies - cooked and raw; smaller portions; canned fruit for a dessert but did not drink the liquid - syrup; etc.

Most of all, no seizures in wks!!! I am SO glad.

OH, I also WALKED up to and back from the central main building dining room for 2 meals - live in a facility and it is a LONG walk!!!

Hope everyone had a good day - blessings!!

[RobinN]

Abstract
Hypoglycemia, a commonly encountered metabolic emergency, is most often easily diagnosed and rapidly treated with satisfactory patient outcome. If not recognized and treated promptly, hypoglycemia may cause irreversible central nervous system injury; it rarely results in death. The classic presentation of hypoglycemia, a patient with diabetes mellitus on medical therapy (insulin or oral hypoglycemic agents) who presents with an altered sensorium, is frequently seen in the emergency department (ED). Less often, patients with this metabolic emergency present to the ED in a manner suggestive of a situation other than hypoglycemia. Patients may present with seizure activity or focal neurological deficits, leading the physician to treat a primary neurological syndrome and not immediately recognize the primary cause of the problem. Alternatively, patients with hypoglycemia will present to the ED with an altered mental status after a traumatic event. The physician may again assume that the alteration in consciousness has resulted from a head injury and not a metabolic disorder. Four cases are presented in which the medical history of the event (ie, trauma) suggested head injury as an explanation of the presentation when, in fact, hypoglycemia was responsible for the altered sensorium. The diagnosis of hypoglycemia is easily made with the performance of a bedside screening test which can be subsequently confirmed by laboratory blood analysis. It is imperative that emergency physicians consider hypoglycemia in all patients with any mental status abnormality, focal neurological deficit, or seizure activity, even when the findings seem to be explained initially by other etiologies.

Abstract

Leucine-hypersensitive hypoglycemia is a rare clinical entity that is usually diagnosed after an exhaustive search for other causes of hypoglycemia. In nonsurgical patients, an imbalance between metabolic demands and gluconeogenesis are most frequently responsible for recurrent symptomatic hypoglycemia. In the postoperative patient, hypoglycemia more commonly results from inadequate energy intake or malabsorption from functional or anatomical abnormalities. Presented here is an unusual case of a child who was initially diagnosed with postoperative gastrocolic fistula and dumping syndrome as the cause of hypoglycemia but later found to have leucine-hypersensitive hypoglycemia.

http://www.sciencedirect.com/science...3ab82b1eff8120

[Cint]

From the American Diabetes Association:

What are the symptoms of hypoglycemia?

The symptoms of hypoglycemia include:

Shakiness*
Dizziness
Sweating
Hunger
Headache
Pale skin color
Sudden moodiness or behavior changes, such as crying for no apparent reason
Clumsy or jerky movements
Seizure
Difficulty paying attention, or confusion*
Tingling sensations around the mouth*

* notorious symptoms for me

Hypoglycemia Unawareness

Some people have no symptoms of hypoglycemia. They may lose consciousness without ever knowing their blood glucose levels were dropping. This problem is called hypoglycemia unawareness.

Hypoglycemia unawareness tends to happen to people who have had diabetes for many years. Hypoglycemia unawareness does not happen to everyone. It is more likely in people who have neuropathy (nerve damage), people on tight glucose control, and people who take certain heart or high blood pressure medicines.

As the years go by, many people continue to have symptoms of hypoglycemia, but the symptoms change. In this case, someone may not recognize a reaction because it feels different.

These changes are good reason to check your blood glucose often, and to alert your friends and family to your symptoms of hypoglycemia. Treat low or dropping sugar levels even if you feel fine. And tell your team if your blood glucose ever drops below 50 mg/dl without any symptoms.

[RobinN]

My daughter has no symptoms. She does not fall into the catagory you post of people most likely to have this. She is not diabetic.

I wonder if the symptoms that you listed, would be far different for children. They simply are not in tune with their bodies as adults are, and are often into multiple sports, and simply pick up a sugar drink if they are feeling a bit weak. Without realizing what they are doing. Parents don't know that anything out of the ordinary is occuring and are simply unaware until it is too late.