Insulinoma as a Potential Insidious Presenter in Medical Refractory Epilepsy.


Journal

Neuro endocrinology letters
ISSN: 2354-4716
Titre abrégé: Neuro Endocrinol Lett
Pays: Sweden
ID NLM: 8008373

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 04 08 2019
accepted: 12 12 2019
pubmed: 28 4 2020
medline: 26 8 2021
entrez: 28 4 2020
Statut: ppublish

Résumé

Insulinoma as a cause of epileptic seizure has been thoroughly described but often not considered in differentials for previously established diagnoses of seizure disorder. Hypoglycemic symptoms can mimic neurological disorders such as epilepsy. A 52-year-old woman presented with a history of epilepsy on anti-epileptic drugs (AEDs) developed repeated episodes consisting of seizures and neuropsychiatric symptoms with no predisposing factors for epilepsy at age 52. She had received full AED treatment before the possibility of hypoglycemia was considered. Following a clinical diagnosis of insulinoma, distal pancreatectomy was performed, and her seizures did not occur again. The early diagnosis of insulinoma requires vigilance, not only for hypoglycemia in patients with neuropsychiatric symptoms, but also for the possible masking effects of a history of epilepsy and preceding AED usage.

Sections du résumé

BACKGROUND BACKGROUND
Insulinoma as a cause of epileptic seizure has been thoroughly described but often not considered in differentials for previously established diagnoses of seizure disorder. Hypoglycemic symptoms can mimic neurological disorders such as epilepsy.
CASE PRESENTATION METHODS
A 52-year-old woman presented with a history of epilepsy on anti-epileptic drugs (AEDs) developed repeated episodes consisting of seizures and neuropsychiatric symptoms with no predisposing factors for epilepsy at age 52. She had received full AED treatment before the possibility of hypoglycemia was considered. Following a clinical diagnosis of insulinoma, distal pancreatectomy was performed, and her seizures did not occur again.
CONCLUSION CONCLUSIONS
The early diagnosis of insulinoma requires vigilance, not only for hypoglycemia in patients with neuropsychiatric symptoms, but also for the possible masking effects of a history of epilepsy and preceding AED usage.

Identifiants

pubmed: 32338852
pii: NEL410120C03

Substances chimiques

Anticonvulsants 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

46-52

Auteurs

Malik Ghannam (M)

Department of Neurology, University of Minnesota, Minneapolis, MN, USA.

Azizullah Beran (A)

Department of Internal Medicine, the University of Toledo, Toledo, OH, USA.

Dana Ghazaleh (D)

Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA.

Ryan Lyerla (R)

Department of Endocrinology, University of Minnesota, Minneapolis MN, USA.

Rami Al-Assadi (R)

Department of Neurology, University of Minnesota, Minneapolis, MN, USA.

Tanner Ferderer (T)

Department of Neurology, University of Minnesota, Minneapolis, MN, USA.

Bahareh Elahian (B)

Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

Thomas Henry (T)

Department of Neurology, University of Minnesota Health/MINCEP Epilepsy Care, 5775 Wayzata Blvd, Minneapolis, MN 55416, USA.

Sima Patel (S)

Department of Neurology, University of Minnesota Health/MINCEP Epilepsy Care, 5775 Wayzata Blvd, Minneapolis, MN 55416, USA.

Brent Berry (B)

Department of Neurology, University of Minnesota, Minneapolis, MN, USA.

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Classifications MeSH