A non-typical Epileptic Reaction in a Patient with Insulinoma of the Pancreas: A Case Report
Journal Title: International Journal of Medical and Pharmaceutical Case Reports - Year 2017, Vol 9, Issue 5
Abstract
Extreme hypoglycemia in cases with insulinoma may be clinically manifested with epileptic reactions, most frequently described in literature as generalized tonic-clonic seizures. We present a case of a 30-year old man who was hospitalized at the Clinic of Neurology of the University hospital “St. George” in Plovdiv, Bulgaria, because of frequent seizures (2-3/ week), manifested with impaired awareness, aggressiveness, agitation, and confusion, mainly in the morning. The patient had been initially treated in a psychiatric clinic, afterwards he was diagnosed with epilepsy and was treated with valproate without success. During his stay in the Clinic of Neurology the medical staff observed a couple of focal seizures with impaired awareness, turning head aside, fixed eyes, followed by aggressiveness, agitation, and postictal confusion. Extremely low levels of blood sugar were measured in the morning – up to 1.3 mmol/l (referent limits 4.1-5.9 mmol/l). The polysomnography recording showed episodes of high voltage synchronous slow activity in all derivations at the time of the described above seizures and hypoglycemia, which were coped with 40% glucose solution. Insulinoma in contact with the tail of the pancreas was verified as a metabolically active lesion on PET/CT. The patient was directed to a surgical department for biopsy and treatment. Seizures stopped after surgical resection of insulinoma. We consider the reported case is a diagnostic challenge because of the type of clinical manifestations and the absolute necessity of highly specialized imaging investigations for etiology precision.
Authors and Affiliations
Z. Vasileva, E. Viteva, K. Terziiski, A. Trenova
Keywords
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- EP ID EP309441
- DOI 10.9734/IJMPCR/2017/36078
- Views 100
- Downloads 0
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