Neonatal hypoglycemic brain injury is a cause of infantile spasms

Yang,Guang; Zou,Li‑Ping; Wang,Jing; Shi,Xiuyu; Tian,Shuping; Yang,Xiaofan; Ju,Jun; Yao,Hongxiang; Liu,Yujie

doi:10.3892/etm.2016.3107

Neonatal hypoglycemic brain injury is a cause of infantile spasms

Authors:
- Guang Yang
- Li‑Ping Zou
- Jing Wang
- Xiuyu Shi
- Shuping Tian
- Xiaofan Yang
- Jun Ju
- Hongxiang Yao
- Yujie Liu
View Affiliations

Affiliations: Department of Pediatrics, Chinese PLA General Hospital, Beijing 100853, P.R. China, Department of Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China
Published online on: February 25, 2016 https://doi.org/10.3892/etm.2016.3107
Pages: 2066-2070

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Neonatal hypoglycemic brain injury is one of the causes of infantile spasms. In the present study, the clinical history and auxiliary examination results of 18 patients who developed infantile spasms several months after neonatal hypoglycemia were retrospectively analyzed. Among the 666 patients with infantile spasms admitted to two pediatric centers between January 2008 and October 2012, 18 patients developed infantile spasms after being diagnosed with neonatal hypoglycemia, defined as a whole blood glucose concentration of <2.6 mmol/l. These patients developed infantile spasms from between 2 and 10 months (mean, 4.9 months) following the diagnosis of neonatal hypoglycemia. All 18 patients had abnormal electroencephalographic findings with either classical or modified hypsarrhythmia. Upon examination using brain magnetic resonance imaging (MRI), 10 patients (55.6%) exhibited abnormalities. The MRI results principally showed a disproportional involvement of parietal and occipital cortices and sub‑cortical white matter lesions. In conclusion, the results of this study indicate that neonatal hypoglycemic brain injury is associated with the subsequent development of infantile spasms.

View Figures

View References

1	Pellock JM, Hrachovy R, Shinnar S, Baram TZ, Bettis D, Dlugos DJ, Gaillard WD, Gibson PA, Holmes GL, Nordl DR, et al: Infantile spasms: A US consensus report. Epilepsia. 51:2175–2189. 2010. View Article : Google Scholar : PubMed/NCBI
2	Lux AL: Latest American and European updates on infantile spasms. Curr Neurol Neurosci Rep. 13:3342013. View Article : Google Scholar : PubMed/NCBI
3	Pavone P, Striano P, Falsaperla R, Pavone L and Ruggieri M: Infantile spasms syndrome, West syndrome and related phenotypes: What we know in 2013. Brain Dev. 36:739–751. 2014. View Article : Google Scholar : PubMed/NCBI
4	Trevathan E, Murphy CC and Yeargin-Allsopp M: The descriptive epidemiology of infantile spasms among Atlanta children. Epilepsia. 40:748–751. 1999. View Article : Google Scholar : PubMed/NCBI
5	Go CY, Mackay MT, Weiss SK, Stephens D, Adams-Webber T, Ashwal S and Snead OC III: Child Neurology Society; American Academy of Neurology: Evidence-based guideline update: Medical treatment of infantile spasms. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 78:1974–1980. 2012. View Article : Google Scholar : PubMed/NCBI
6	Hrachovy RA and Frost JD Jr: Infantile spasms. Handb Clin Neurol. 111:611–618. 2013. View Article : Google Scholar : PubMed/NCBI
7	Osborne JP, Lux AL, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Newton RW, Verity CM and O'Callaghan FJ: The underlying etiology of infantile spasms (West syndrome): Information from the United Kingdom infantile spasms study (UKISS) on contemporary causes and their classification. Epilepsia. 51:2168–2174. 2010. View Article : Google Scholar : PubMed/NCBI
8	Yu JY and Pearl PL: Metabolic causes of epileptic encephalopathy. Epilepsy Res Treat. 2013:1249342013.PubMed/NCBI
9	Camurdan MO, Cinaz P, Serdaroğlu A, Bideci A and Demirel F: Persistent hyperinsulinemic hypoglycemia presenting with a rare complication: West syndrome. J Pediatr Endocrinol Metab. 17:1465–1468. 2004.PubMed/NCBI
10	Kumaran A, Kar S, Kapoor RR and Hussain K: The clinical problem of hyperinsulinemic hypoglycemia and resultant infantile spasms. Pediatrics. 126:e1231–e1236. 2010. View Article : Google Scholar : PubMed/NCBI
11	Rozance PJ: Update on neonatal hypoglycemia. Curr Opin Endocrinol Diabetes Obes. 21:45–50. 2014. View Article : Google Scholar : PubMed/NCBI
12	Boardman JP, Wusthoff CJ and Cowan FM: Hypoglycaemia and neonatal brain injury. Arch Dis Child Educ Pract Ed. 98:2–6. 2013. View Article : Google Scholar : PubMed/NCBI
13	Vijay K and Agarwal A: Neonatal hypoglycemia resulting in occipital cerebral injury. Pediatr Radiol. 40(Suppl 1): S1782010. View Article : Google Scholar : PubMed/NCBI
14	Udani V, Munot P, Ursekar M and Gupta S: Neonatal hypoglycemic brain-injury a common cause of infantile onset remote symptomatic epilepsy. Indian Pediatr. 46:127–132. 2009.PubMed/NCBI
15	Montassir H, Maegaki Y, Ogura K, Kurozawa Y, Nagata I, Kanzaki S and Ohno K: Associated factors in neonatal hypoglycemic brain injury. Brain Dev. 31:649–656. 2009. View Article : Google Scholar : PubMed/NCBI
16	Termote B, Verswijvel G, Gelin G and Palmers Y: Neonatal hypoglycemic brain injury. JBR-BTR. 91:116–117. 2008.PubMed/NCBI
17	Jain P, Sharma S and Tripathi M: Diagnosis and management of epileptic encephalopathies in children. Epilepsy Res Treat. 2013:5019812013.PubMed/NCBI
18	Harris DL, Weston PJ, Signal M, Chase JG and Harding JE: Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): A randomised, double-blind, placebo-controlled trial. Lancet. 382:2077–2083. 2013. View Article : Google Scholar : PubMed/NCBI
19	Papagapiou MP and Auer RN: Regional neuroprotective effects of the NMDA receptor antagonist MK-801 (dizocilpine) in hypoglycemic brain damage. J Cereb Blood Flow Metab. 10:270–276. 1990. View Article : Google Scholar : PubMed/NCBI
20	Ballesteros JR, Mishra OP and McGowan JE: Alterations in cerebral mitochondria during acute hypoglycemia. Biol Neonate. 84:159–163. 2003. View Article : Google Scholar : PubMed/NCBI
21	Suh SW, Gum ET, Hamby AM, Chan PH and Swanson RA: Hypoglycemic neuronal death is triggered by glucose reperfusion and activation of neuronal NADPH oxidase. J Clin Invest. 117:910–918. 2007. View Article : Google Scholar : PubMed/NCBI
22	Imai T, Kondo M, Isobe K, Itoh S and Onishi S: Cerebral energy metabolism in insulin induced hypoglycemia in newborn piglets: In vivo ³¹P-nuclear magnetic resonance spectroscopy. Acta Paediatr Jpn. 38:343–347. 1996. View Article : Google Scholar : PubMed/NCBI
23	Wong DS, Poskitt KJ, Chau V, Miller SP, Roland E, Hill A and Tam EW: Brain injury patterns in hypoglycemia in neonatal encephalopathy. AJNR Am J Neuroradiol. 34:1456–1461. 2013. View Article : Google Scholar : PubMed/NCBI
24	Guggenheim MA, Frost JD Jr and Hrachovy RA: Time interval from a brain insult to the onset of infantile spasms. Pediatr Neurol. 38:34–37. 2008. View Article : Google Scholar : PubMed/NCBI
25	Frost JD Jr and Hrachovy RA: Pathogenesis of infantile spasms: A model based on developmental desynchronization. J Clin Neurophysiol. 22:25–36. 2005. View Article : Google Scholar : PubMed/NCBI
26	Shang NX, Zou LP, Zhao JB, Zhang F and Li H: Association between prenatal stress and infantile spasms: A case-control study in China. Pediatr Neurol. 42:181–186. 2010. View Article : Google Scholar : PubMed/NCBI
27	Zou LP, Zhang WH, Wang HM, Zen M, Chen K and Mix E: Maternal IgG suppresses NMDA-induced spasms in infant rats and inhibits NMDA-mediated neurotoxicity in hippocampal neurons. J Neuroimmunol. 181:106–111. 2006. View Article : Google Scholar : PubMed/NCBI
28	Shi XY, Zou LP, Yang G and Ding YX: Prenatal stress exposure hypothesis for infantile spasms. Med Hypotheses. 78:735–737. 2012. View Article : Google Scholar : PubMed/NCBI
29	Nold JL and Georgieff MK: Infants of diabetic mothers. Pediatr Clin North Am. 51:619–37. 2004. View Article : Google Scholar : PubMed/NCBI
30	Najati N and Saboktakin L: Prevalence and underlying etiologies of neonatal hypoglycemia. Pak J Biol Sci. 13:753–756. 2010. View Article : Google Scholar : PubMed/NCBI
31	McGowan JE, Zanelli SA, Haynes-Laing AG, Mishra OP and Delivoria-Papadopoulos M: Modification of glutamate binding sites in newborn brain during hypoglycemia. Brain Res. 927:80–86. 2002. View Article : Google Scholar : PubMed/NCBI
32	Chugani HT, Shewmon DA, Shields WD, Sankar R, Comair Y, Vinters HV and Peacock WJ: Surgery for intractable infantile spasms: Neuroimaging perspectives. Epilepsia. 34:764–771. 1993. View Article : Google Scholar : PubMed/NCBI
33	Hamano S, Tanaka M, Kawasaki S, Nara T, Horita H, Eto Y and Kohno S: Regional specificity of localized cortical lesions in West syndrome. Pediatr Neurol. 23:219–224. 2000. View Article : Google Scholar : PubMed/NCBI