Abstract

Background: Idiopathic ketotic hypoglycemia (IKH) is a common cause of hypoglycemia in young children, characterized by episodes of symptomatic hypoglycemia in the absence of an underlying endocrine or metabolic disorder. It primarily affects toddlers and young children and is associated with a decreased tolerance to fasting. While the condition is not rare, it is often underdiagnosed or overlooked in clinical practice.
Case Presentation: We report a case of a 4-year-old girl who presented with recurrent episodes of loss of consciousness. These episodes occurred without any preceding illness and were not triggered by hypoglycemic medications. The child was evaluated using an electroencephalogram and neuroimaging to rule out central nervous system (CNS) causes such as seizures or brain abnormalities. Both investigations yielded normal results. After excluding other potential causes, the diagnosis of IKH was made based on her clinical presentation and history of fasting-induced hypoglycemia.
Conclusion: This case highlights the importance of considering IKH in children presenting with unexplained hypoglycemic episodes, particularly when CNS causes are ruled out. Early recognition and dietary management, including a proper complex carbohydrate diet, can effectively prevent future episodes and avoid unnecessary diagnostic workups and treatments.

Key words: . Keywords: Idiopathic Ketotic Hypoglycemia , Pediatric Hypoglycemia , Hypoglycemia , Fasting Hypoglycemia , Case Report