Episodes nearly always occur in the morning after an overnight fast, often longer than usual. Symptoms
include those of neuroglycopenia, ketosis
, or both. The neuroglycopenic symptoms
usually include lethargy and malaise, but may include unresponsiveness or seizures. The principal symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomiting.
If severe, parents usually take the child to a local emergency department, where blood is drawn.