Hypoglycemic encephalopathy is a metabolic encephalopathy due to extremely low blood glucose levels. Such patients often suffer from the disease, is initially characterized by multiple symptoms such as confusion, mental and behaviour disorders, and adverse physical activity. It can last over a period of time, or symptoms may be alleviated after eating. If the treatment is not administered in time, the disease will further develop into drowsiness, lethargy, and even a coma, and ultimately cause death.
A toxin found in litchi fruit was responsible for causing hypoglycaemic encephalopathy. In 2017, scientists from India and the U.S. confirmed the role of toxin behind the death caused in Bihar. The toxin is called methyl cyclopropyl glycine (MCPG).
Early morning, when the body is in fasting state there is a normal tendency for the blood sugar to dip down the normal level, after several hours of no food intake. Malnourished children who had gone to sleep without a meal at night had a tendency of developing hypoglycaemia.
The brain needs a normal level of glucose in the blood for its functioning. The liver is unable to supply the need. So the alternative pathway of glucose synthesis called fatty acid breakdown gets started. But, that pathway is blocked by MCPG.
When glycogen reserve is exhausted in the liver, the body converts the fatty acid into glucose. But in the presence of that toxin, the conversion of fatty acid into glucose is stopped. As a result, no glucose is produced in the body, and in turn, amino acids are released, which are toxic to the brain cells. The amino acid cause brain cells to swell causing brain oedema and as a result, children may suffer from convulsions, coma and even death. So, the undernourished children should not eat plenty of litchi fruit on an empty stomach, and they should eat food properly and not go to bed on an empty stomach, can easily prevent the cause of hypoglycaemic encephalopathy.1
Factors which was responsible for the death in Bihar was lack of immunity, improper sanitization techniques, contaminated water, hot weather, deficiency of different nutrients. Litchi was not the only cause behind the death. Litchi fruit does not cause any harm in well-nourished individuals. But, it should not be consumed on an empty stomach or in fasting state.