Twardowschy Carlos Alexandre, Leite Silmara Aparecida de Oliveira, Outi Tatiana Yukie, Dykyj Michelle Totti
Serviço de Clínica Médica, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 2005 Sep;63(3A):685-8. doi: 10.1590/s0004-282x2005000400026. Epub 2005 Sep 9.
Insulinoma is a rare disease presenting with episodic neuroglycopenic and/or adrenergic symptoms. We describe the case of a 36 year-old female that had been in treatment for complex partial seizures during 4 years without improvement. She presented many crises with marking hypoglycemia. Cranium tomography and electroencephalogram were normal. A 72-hour fast test showed hypoglycemic symptoms with raised insulin and C-peptide. The insulinoma localization was possible during exploratory laparatomy; image methods did not reveal the tumor. Histological findings confirmed an insulinoma. We conclude that blood glucose level should be requested during the investigation of convulsive and behavioral disorders since an insulinoma can present like them.
胰岛素瘤是一种罕见疾病,表现为发作性神经低血糖和/或肾上腺素能症状。我们描述了一名36岁女性的病例,她因复杂部分性癫痫接受了4年治疗但无改善。她出现了许多伴有明显低血糖的发作。头颅CT和脑电图均正常。72小时禁食试验显示低血糖症状,同时胰岛素和C肽升高。在探查性剖腹手术中确定了胰岛素瘤的位置;影像学方法未发现肿瘤。组织学检查结果证实为胰岛素瘤。我们得出结论,在调查惊厥和行为障碍时应检测血糖水平,因为胰岛素瘤可能表现为类似症状。