title: Duration of nocturnal hypoglycemia before seizures.
abstract: OBJECTIVE
  Despite a high incidence of nocturnal hypoglycemia documented by the use of continuous glucose monitoring (CGM), there are no reports in the literature of nocturnal hypoglycemic seizures while a patient is wearing a CGM device.
  
  
  METHODS
  In this article, we describe four such cases and assess the duration of nocturnal hypoglycemia before the seizure.
  
  
  RESULTS
  In the cases where patients had a nocturnal hypoglycemic seizure while wearing a CGM device, sensor hypoglycemia (<60 mg/dl) was documented on the CGM record for 2.25-4 h before seizure activity.
  
  
  CONCLUSIONS
  Even with a subcutaneous glucose lag of 18 min when compared with blood glucose measurements, glucose sensors have time to provide clinically meaningful alarms. Current nocturnal hypoglycemic alarms need to be improved, however, since patients can sleep through the current alarm systems.
authors.affiliation: Lucile Packard Children's Hospital at Stanford, Pediatric Endocrinology, Stanford, California, USA. buckingham@stanford.edu.
authors.forename: Bruce
authors.initials: B
authors.lastname: Buckingham
authors.forename: Darrell M
authors.initials: DM
authors.lastname: Wilson
authors.forename: Todd
authors.initials: T
authors.lastname: Lecher
authors.forename: Ragnar
authors.initials: R
authors.lastname: Hanas
authors.forename: Kevin
authors.initials: K
authors.lastname: Kaiserman
authors.forename: Fergus
authors.initials: F
authors.lastname: Cameron
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002940:Circadian Rhythm; D004827:Epilepsy / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis*; D008297:Male
chemical_list: D001786:Blood Glucose