Hypoglycemia and Acidosis in Fasting Children With Idiopathic Epilepsy

Abstract

Fasting of late has been frequently employed in the therapeutics of epilepsy, and numerous reports of fasts for this purpose are found in the literature. In the majority of cases, improvement of at least a transient nature follows fasting but permanent cure has not been demonstrated. Thus far, no consistent explanation has been advanced for the improvement which occurs.During the last two years, nineteen fasts have been carried out on epileptic children in this clinic. During the fast these cases have been studied, in order to determine the effect of fasting on the metabolism, with the hope that some constant change might serve to explain the improvement of the epileptic symptoms during the fast and perhaps form a rational basis for further treatment.Studies carried out in some of these cases have formed the basis of a previous report,1 and it is the purpose of this paper to present certain more or less significant findings as exemplified in a series of five additional cases, which serve to extend and corroborate the previously reported data. The cases which comprise this series varied in the degree of their symptomatology from mild to moderately severe epilepsy. There was little in the history, the physical examination, or the findings in labora¬ tory studies carried out before the fast which showed departure from the normal other than the occurrence of epileptiform seizures. Briefly, the individual status was as follows :REPORT OF CASES Case 1.-J. B., a girl, aged 9 years, whose parentage was excellent physically and mentally ; there was no familial taint of any kind. Her early history was uneventful. Epileptic attacks commenced four years before entry to this hos-

Pulmonary Gas Exchange

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Total Acid-Base Equilibrium of Plasma in Health and Disease

“…Case 5. A stout female, aged 53, admitted to the hospital November 20,1922, with an acute attack of recurrent arthritis with fever. At the time of the venipuncture her temperature was only 99.6°F.…”

Functional Hypoglycemia of Childhood

“…10 Rumpf demonstrated that the carbohydrate reserve of newly born infants is exhausted in twenty-four hours, and he suggested that the ease with which this phenomenon occurs is directly proportional to the age of the infant. It has been established that fasting in children causes a rapid and profound exhaustion of the glycogen reserve.…”