Hypoglycemic encephalopathy

Hypoglycemic encephalopathy

    * Introduction
    * Clinical
    * Diagnostic Laboratory
    * Treatment
Hypoglycemia is seen in the lower concentration of blood sugar. The normal range is between 65-110 mg% glucose. In people over 45-50 years the mean blood glucose values are slightly higher than in young people, to the upper limit of normal, because the consumption of glucose in the body is reduced with the age.
The main source of energy the brain is glucose, so it appears that in the absence of severe neural defects. The brain can not function without glucose than for a few minutes so severe hypoglycemia is a medical emergency where you have intervened promptly, otherwise the patient can be life threatening. The brain consumes about 60% of glucose, which is in general circulation and needs 450 calories a day. As the brain can not store glucose and to make reservations, he always extracted from the blood.
Hypoglycemia is not considered a disease itself but rather in a state. Hypoglycemia results from multiple causes, the main ones being: - An overdose of insulin in the treatment of diabetes, which is the most common cause - Lack of food for long periods of time or poor nutrition, for example in severe post. The total lack of food, hypoglycemia occurs within hours. - Administration of drugs, consumption of alcoholic beverages. In chronic alcoholics hypoglycemia occurs on a background of insufficient food, knowing that alcoholics lose their hunger, replacing food with booze. - Hereditary disease that affects the metabolism of carbohydrates - Island-cell tumors secreting insulin, retroperitoneal sarcomas
Hypoglycemia is common in other medical conditions such as malignancies and chronic alcoholism. Clinical signs of hypoglycaemia, is announcing the installation of hot flashes, rapid heart rate, anxiety and strong sensation of hunger. If not promptly intervene to combat hypoglycemia, serious disturbances occur in the central nervous system, initially by setting up a slight confusion that may progress to lethargy and delirium, convulsions and installation phenomena followed by a state of coma. If hypoglycemia persists, can lead to irreversible brain damage.
Pathogenesis
The central nervous system in relation to serum glucose levels. When blood sugar level drops to about 25 mg%, confusion and delirium is installed. Rates of glucose metabolism in the brain decreases much faster than the rate of oxygen metabolism, demonstrating that central nervous system using different substrates to glucose in crisis situations such as hypoglycemia. These substrates include the tricarboxylic acid cycle intermediates and amino acids, especially glutamate. However, these substrates are rapidly consumed by nervous tissue, these reserves are sufficient for only a few minutes in the absence of glucose. If decreases in serum glucose around 20 mg%, the initial wave amplitude encephalogram appear high and low frequency, followed by lower amplitude and frequency. Registered on EEG changes and clinical disorders of the plan is explained by reduction of neurotransmitters due to the scarcity of energy. The serum glucose concentrations below 20 mg%, to install the depletion levels of ATP (adenosine trifosforic acid) of nerve cells, a line isoelectric EEG records and the patient into a coma.