Introduction

Neonatal Hypoglycemia is an important cause of neonatal seizures, resulting into a typical pattern of brain injury on MRI with subsequent development of epilepsy and developmental delay. We retrospectively studied the data of children with MRIs showing neonatal hypoglycemic brain injury  and neurodevelopmental outcome.

Methods

We reviewed the 108 children following up in neurology clinic with typical MRI features of neonatal hypoglycemic brain injury. Children with history of HIE ,congenital anomalies were excluded. Details of clinical presentation, epilepsy,developmental delay or intellectual disability,autistic spectrum disorder, and visual impairment were noted Developmental and cognitive assessment was done with age appropriate validated tests.

Results

Review of 108 children(84 boys and 24 girls) with MRI showing features of neonatal hypoglycemic brain insult and history of acute neurological symptoms in first week,was done. 30/108 (27%) were born by LSCS and history of PIH, oligohydramnios was common. 66/108(61%) were low birth weight .

Remote symptomatic seizures were present in 88% of cases. Developmental delay documented seen in 92%(100/108) of children . Moderate to severe intellectual disability was seen in 66/108(61%) children. Cortical visual impairment  was present in 64/108(59%), and squint noted in 76% of all children. Autistic features were observed in 46/108 (42%)children. ADHD was also noted frequently. Normal developmental outcome was seen in 8/108 (7%) of children.

Conclusions

Symptomatic neonatal hypoglycaemia resulting into MRI abnormalities is associated with very high incidence of intellectual disabilities and cortical visual impairment.