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Heavy breathing, loss of consciousness with convulsions. Reason?

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What medical tests should I be getting my child?

We're on vacation in a foreign country with less than ideal medical facilities for the summer. My child had an incident and needed a short emergency hospital visit several days ago. I would like to go to a larger city with better facilities to have further testing done to rule out anything major, but thanks to language barriers here I would really like to know exactly what the doctors should be looking for (and why) so I can find facilities that offer it, request it, have some idea of what is going on, and get it all done in one swoop if possible. My just showing up speaking the wrong language without information isn't going to have great results if our visit to emergency was any indication.

12 year old girl, otherwise healthy. Nothing more than a cold in the previous 7 or so years.
She was breathing heavily, then lost consciousness, fell to the floor and started convulsing. The seizure lasted for probably less than 10 seconds. She regained consciousness within another 10 seconds, and seemed recovered after about 5 minutes (other than a chipped tooth). She was really pale - her lips were white - for a little while after. This is her first incident of this type.

We gave her a juice box when she regained consciousness, so if it was glucose related (could be, her mother - me - has mild hypoglycemia), I'm not sure the tests done after that would have picked it up? Also, on that note, it was about 11 a.m. and she had skipped breakfast that morning. In the previous week she had a similar day (skipped breakfast) and complained of dizziness at around the same time. I don't really recall her ever complaining of dizziness prior to that.

After the seizure, she was taken to the hospital here, given a glucose drip, a saline drip, and a third thing that I don't know what it was (it was inserted into one of the drips). She seemed fine other than a high level of anxiety which eventually dissipated. They took blood (photos of the test results are attached, they're in Albanian, but some of the stuff is obvious enough) and released us with a prescription for vitamins when the results came back. I was told if I wanted to know the cause that I would have to go see a doctor elsewhere (the hospital pediatric ward was staffed solely by nurses).

She has appeared fine in the days since the incident. We've put her on a diet safe for hypoglycemics in case that was the cause and she has been taking the prescribed vitamins and drinking plenty of fluids, etc.

Medical history:

Danazol baby - exposed from zero to 2 months gestation

Born 3 weeks early w/ pulmonary artery stenosis - resolved on its own by age 2 or 3.

Had behavioral incidents of holding her breath until she passed out multiple times between about ages 1-3.

Multiple severe headaches between ages 4-7 (approx)

Age 5 - Head injury on the playground at school - required stitches over her left eye. She began developing academic problems shortly after due to a very poor working memory. Academics are still a bit of a nightmare.


Note from mom on Addison's disease (thanks to google mainly) - We have a heritage that has a higher incidence rate that the general populace and many of my own symptoms over life could match up. I never passed out and had a seizure, so never sought medical intervention to find out exactly what was wrong.
Also, if you happen to be into genetics: her autosomal DNA results say she is at increased risk for Addison's thanks to the gene rs12150220(A;A). (We did DNA genealogy a while back to learn more about our roots - but it's always interesting to pull up when medical issues arise).

Attached: lab results from hospital, plus photos taken at hospital and a restaurant after

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 19 Doctors Online

Dear Parent,
Thanks for your query at
I can understand your concerns. At the outset, I must thank you for providing me with a detailed and relevant history containing all the important medical details.

Analyzing the whole sequence of events, the seizures could be because of one of the following reasons:
1. Hypoglycemia-related
2. Heat-related or dehydration-related (though unlikely considering the current weather in Albania)

Your description of events and the suspicion is accurate. The most likely cause of the seizure was low blood sugar levels. The brain depends on glucose, and too little can impair its ability to function. Severe or prolonged hypoglycemia could result in seizures and serious brain injury.The vast majority of episodes of hypoglycemia in children and adolescents occur when a child with diabetes takes too much insulin and/or eats too little or exercises strenuously or for a prolonged period of time.
For non-diabetic children, the list of causes is entirely different. Single episodes may be caused by stomach flu, or another illness that may cause them to not eat enough, fasting for a prolonged period of time, prolonged strenuous exercise and lack of food. Recurrent episodes are usually caused by accelerated starvation, also known as “ketotic hypoglycemia', medications your child may be taking, a congenital (present at birth) error in metabolism or unusual disorder such as hypopituitarism, Addison's disease or hyperinsulinism. Other causes of hypoglycemia in children are rare.
I have gone through all her reports (blood tests). They do not provide any clue towards her underlying etiology. Blood glucose has been documented as normal. But, it could be fallacious because she drank juice before reaching the hospital. I would suggest that you do the following:
1. Get a fasting blood glucose tested in the morning within an hour or two of her waking up.
2. Get serum sodium and potassium (sodium and potassium disturbances may cause seizures; and may also be abnormal in Addison's disease or any corticosteroid insufficiency)
3. Get her serum total calcium, ionized calcium and phosphate levels.
This should suffice as of now. If she has a recurrence of such an episode, check her sugar using a hand-held glucometer. If she is indeed hypoglycemic, she may require a visit to a pediatric endocrinologist. She would then need her plasma insulin, serum cortisol, and C-peptide levels tested.
Till then, please make sure that she eats frequent meals and snacks throughout the day and has something to eat before going to bed. If she eats little at dinner, a hearty snack before bedtime (such as a glass of milk and peanut butter on toast) will keep her blood sugar levels stable throughout the night and in the early morning.
Dr. Saptharishi L G

Dr. Saptharishi L G
DM (Pediatric Critical Care) Senior Resident
MBBS, MD (Pediatrics), PGDCRL
Division of Pediatric Critical Care

Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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