Neonatal hypoglycemia is reported to be one of the risk factors for neurodevelopmental disorders including autism spectrum disorder (ASD). We present two boys with history of neonatal hypoglycemia and diagnosed as ASD at early childhood. The pathogenetic processes which might be leading to the maldevelopment of central nervous system will also be reviewed. Glutamate is the most important excitatory neurotransmitter in the brain and excitotoxicity is blamed as the major mechanism for the perinatal brain injury. Perinatal complications such as hypoxia, ischemia, stroke, kernicterus and trauma might result with disruption of the synaptic function, accumulation of glutamate in the extracellular space and overexcitation of these neurons. It is hypothesized that the overexcitation of glutamate receptor/ion channel complexes lead to the accumulation of calcium and pathogenetic mechanisms which might result with apoptosis and necrosis. These processes secondary to the hypoglycemia might deviate the postnatal programmed neuronal apoptosis from its normal course of development and might damage some neuronal groups critical for the normal functioning of circuits disrupted in the pathogenesis of ASD. This opinion overlaps with the current neuronal hypotheses for ASD.
Autism, hypoglycemia, excitotoxicity, glutamate