Suzuki Keisuke, Miyamoto Masayuki, Miyamoto Tomoyuki, Hirata Koichi
Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Intern Med. 2007;46(7):405-8. doi: 10.2169/internalmedicine.46.6071. Epub 2007 Apr 2.
We report a 65-year-old man with insulinoma who initially developed stereotypical behaviors and then progressed to more complex behaviors occurring early in the morning. He could not remember the events during the episodes. Insulinoma was diagnosed based on fasting blood glucose level of 15 mg/dl, high fasting immunoreactive insulin/blood glucose ratio (more than 0.3), and a tumor in the pancreas head by abdominal CT. Hypoglycemia caused by insulinoma should be considered as one of the mechanisms underlying abnormal nocturnal behaviors since the symptoms are very similar to those of sleep-related epilepsy, parasomnia, and night delirium.
我们报告了一名65岁的胰岛素瘤患者，该患者最初出现刻板行为，随后发展为清晨出现的更复杂行为。他记不起发作期间的事情。根据空腹血糖水平为15mg/dl、高空腹免疫反应性胰岛素/血糖比值（超过0.3）以及腹部CT显示胰头有肿瘤，诊断为胰岛素瘤。由于胰岛素瘤引起的低血糖症状与睡眠相关癫痫、异态睡眠和夜间谵妄的症状非常相似，因此应将其视为夜间异常行为的潜在机制之一。
