A blood sugar level was done to exclude hypoglycaemia, a rare but important cause of seizures in children. The blood sugar level was 4.5 mmol/l on arrival at the emergency department. It is important to note the fact that the blood sugar level is normal at the time of presentation to the emergency department (or when the ambulance officers arrive), however, it does not completely exclude the diagnosis of hypoglycaemic seizures. The act of having a seizure can increase the blood sugar level or decrease the blood sugar level.
The impact of the seizure on the blood sugar level is determined by how much glucose is transported between the intracellular versus extracellular space and is impacted on cellular level metabolic activity. It is important to have a blood sugar level at the time of onset of the seizure. If there are any concerns about hypoglycaemia, it would be advisable to arrange a fasting study where blood sugar levels are measured at regular intervals after a period of fasting to document the blood sugar level being maintained in a normal range despite no further substrate being available.
Following the blood sugar level, no further investigations were conducted on Felix. The provisional diagnosis is simple febrile convulsion secondary to viral upper respiratory tract infection.