Which of the following symptoms is NOT typically associated with a hypoglycemic episode?

Severe fatigue is generally not a symptom associated with a hypoglycemic episode. Hypoglycemia, or low blood sugar, typically results in acute and immediate symptoms due to the body’s response to inadequate glucose levels. Common symptoms include agitation, irritability, and sensations of nausea or weakness, which reflect the nervous system's reaction to decreased glucose availability for energy. Unexplained agitation and irritability arise because the brain relies on glucose as its primary fuel source, and when levels drop, it can lead to confusion and mood changes. Nausea and weakness can also occur due to the body’s response to the stress of low blood sugar.

In contrast, severe fatigue might be more characteristic of other conditions like prolonged illness, sleep deprivation, or situations involving chronic low-grade stress rather than acute hypoglycemia. Therefore, in the context of hypoglycemia, severe fatigue is less relevant as an immediate symptom.