Clinical Outcome and Magnetic Resonance Imaging Findings in Infants With Hypoglycemia

Çaksen, Hüseyîn; Güven, Ahmet Sami; Yılmaz, Cahide; Ünal, Özkan; Başaranoğlu, Murat; Sal, Ertan; Kaya, Avni

doi:10.1177/0883073810371508

Cited by 29 publications

(15 citation statements)

References 14 publications

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“…Symptomatic and potentially asymptomatic hypoglycemia episodes are associated with significant cerebral MRI findings as well as a 45% risk of cerebral palsy in infants (11,12,27). In our study, we found no instances of symptomatic hypoglycemia, and we did not attempt to study cerebral MRI findings nor long-term neurodevelopmental outcomes.…”

Section: Discussionmentioning

confidence: 47%

Hypoglycemia Adverse Events in PICUs and Cardiac ICUs

Shea¹,

Spaeder

Sayal

et al. 2013

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 47%

Hypoglycemia Adverse Events in PICUs and Cardiac ICUs

Shea¹,

Spaeder

Sayal

et al. 2013

Pediatric Critical Care Medicine

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“…It has been reported that the posterior white matter is primarily affected in hypoglycemia developing within the first six months of life, whereas the basal ganglion and cortex are affected more in hypoglycemia developing after six months (7). In cranial MRI, hyperintense lesions, gliosis, cortical atrophy, and cystic encephalomalacia could be observed in the white matter in T2/fluid attenuation inversion recovery sequence (11,12). In the present case, the presence of posterior white matter involvement and cystic encephalomalacia were found to be consistent with the literature.…”

Section: Discussionmentioning

confidence: 98%

Cystic Encephalomalacia and Infantile Spasm as a Complication of Transient and Mild Hyperinsulinemic Hypoglycemia

Anık¹,

Anık²,

Ünüvar³

et al. 2016

jpr

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ABS TRACT Öz Hipogliseminin beyin gelişimi üzerine olan olumsuz etkileri ve infantil spazma neden olabileceği iyi bilinmekle birlikte, kısa sürede ve spontan olarak iyileşen hiperinsülinemik hipogliseminin infantil spazma neden olabileceği bildirilmemiştir. İnfantil spazm genellikle yaşamın ilk yılında ortaya çıkan, gövde, boyun ve bacak kaslarının ani, kısa süreli ve genellikle bilateral simetrik motor spazmları olarak tanımlanır. En sık görülen formu olan semptomatik infantil spazm prenatal, perinatal ve postnatal olayalara bağlı ortaya çıkar. Zamanında 3140 gram olarak doğan bebek postnatal ikinci gününde zayıf emme ve beslenme güçlüğü yakınmaları ile getirildi. Hiperinsülinemik hipoglisemi tanısı konan ve intravenöz glukoz infüzyonuna (15 mg/kg/dk) rağmen hipogisemisi devam eden olguya diazoksit başlandı. Bu tedavi ile hipoglisemisi gözlenmeyen olgunun diazoksit dozu kademeli olarak azaltılarak 21. günde kesildi. İzlemde sürekli normoglisemik olan bebek 45. günde fleksör spazmlar nedeni ile başvurdu. Elektroensefalografide modifiye hipsartimi paterni saptandı. Kraniyal manyetik rezonans görüntülemede temperopariyetal beyaz ve gri cevherde kistik ensefalomalazik alanlar gözlendi. Adrenokortikotropik hormon ve vigabatrin tedavileri ile nöbetleri kontrol altına alınamayan olguda topiramat ve valproat tedavilerinden kısmi fayda görüldü. Anahtar Kelimeler: İnfantil spazm, geçici hipoglisemi, hiperinsülinemi Although it is known that hypoglycemia could cause severe negative effects on brain development and also infantile spasm, it has not been reported that transient hyperinsulinemic hypoglycemia, which spontaneously improves over a short time, may cause infantile spasms. Infantile spasm is a disorder of early childhood typically seen in the first year of life, characterized by the occurence of sudden, brief, generally bilateral and symetric motor spasms of the muscles of the trunk, neck and limbs. Infantile spasms are classified as idiopathic or symptomatic. The most common form symptomatic infantile spasms is due to prenatal, perinatal or postnatal insults. A 3140 g, full-term baby was admitted with poor sucking and feeding difficulty on the postnatal second day. The patient was followed-up with the diagnosis of hyperinsulinemic hypoglycemia and intravenous glucose infusion (15 mg/kg/min) was administered, but due to the persistence of hypoglycemia, diazoxide treatment was initiated. Hypoglycemia was not observed under diazoxide treatment and the drug was gradually decreased; treatment was terminated on the 21 st day. The patient was continuously normoglycemic during follow-up and admitted with flexor spasms on the 45 th day. A modified hypsarrhythmia pattern was detected in the electroencephalography. On cranial magnetic resonance imaging, diffuse cystic encephalomalacia areas were observed in the temporoparietal white and gray matter. The convulsions were not completely controlled with adrenocorticotropic hormone and vigabatrin treatments. Topiramate and valproate were administered, by which convulsions were pa...

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“…From the pool of non-randomised studies that reported, or allowed the calculation of, prevalence of outcomes of neonatal hypoglycaemia, we selected three that covered a range of methodologies and study population sizes and focused on a single outcome. [15][16][17] All three researchers assessed these three studies using both assessment tools, discussed discrepancies and reached consensus on how the questions should be interpreted. A further 18 studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] reporting prevalence of outcomes after neonatal hypoglycaemia were then each assessed by combinations of two of the three researchers using both tools.…”

Section: Methodsmentioning

confidence: 99%

Comparison of risk-of-bias assessment approaches for selection of studies reporting prevalence for economic analyses

2020

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ObjectivesWithin cost-effectiveness models, prevalence figures can inform transition probabilities. The methodological quality of studies can inform the choice of prevalence figures but no single obvious candidate tool exists for assessing quality of the observational epidemiological studies for selecting prevalence estimates. We aimed to compare different tools to assess the risk of bias of studies reporting prevalence, and develop and compare possible numerical scoring systems using these tools to set a threshold for inclusion of reports of prevalence in an economic analysis of neonatal hypoglycaemia.DesignAssessments of bias using two tools (Joanna Briggs Institute (JBI) Checklist for Prevalence Studies and a modified version of Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I)) were compared for 18 studies relevant to a single setting (neonatal hypoglycaemia). Inclusions of studies for use in a decision analysis model were considered based on summary scores derived from these tools.ResultsBoth tools were considered easy to use and produced dispersed scores for each of the 40 study–outcome combinations. The modified ROBINS-I scores were more skewed than the JBI scores, particularly at higher thresholds. The studies selected for inclusion are generally the same using either tool; if 50% was used as the cut-off threshold using the Applicable Score both tools would yield the same results. However, the JBI tool is shorter and may be easier to interpret and apply to studies that do not involve a control group, while the modified ROBINS-I tool assesses more methodological detail in studies that include a control group.ConclusionBoth tools performed well for systematically assessing studies that report on outcome prevalence and provided similar discrimination between studies for risk of bias. This convergent validity supports use of both tools for the purpose of assessing risk of bias and selecting studies that report prevalence for inclusion in economic analyses.

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Clinical Outcome and Magnetic Resonance Imaging Findings in Infants With Hypoglycemia

Cited by 29 publications

References 14 publications

Hypoglycemia Adverse Events in PICUs and Cardiac ICUs

Hypoglycemia Adverse Events in PICUs and Cardiac ICUs

Cystic Encephalomalacia and Infantile Spasm as a Complication of Transient and Mild Hyperinsulinemic Hypoglycemia

Comparison of risk-of-bias assessment approaches for selection of studies reporting prevalence for economic analyses

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