Hypoglycemia and hypoglycorrhachia, although they are uncommon causes of refractory seizures and epilepsy, should always be considered because they are potentially treatable conditions. A high index of suspicion and low threshold for testing recurrent blood and at least one cerebrospinal fluid glucose level are required. Jeavons syndrome and other refractory cryptogenic/idiopathic epilepsies may involve symptomatic etiologies, including hyperinsulinism, GLUT1 deficiency, and other metabolic disorders.
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