Abstract
Diagnosis of insulinoma may be delayed when symptoms are nonspecific. Rarely neuroglycopenic symptoms are the primary feature and these patients can be misdiagnosed as having epilepsy or neuropsychiatric disease. We report a case of insulinoma presenting as an adult-onset refractory seizure disorder. The time from onset of symptoms to diagnosis was 9 years. The atypical features of the episodes of hypoglycaemia, and the poor response to treatment led to a review of diagnosis. This case highlights the importance of considering hypoglycaemia in atypical neurological or psychiatric presentations. DOI: http://dx.doi.org/10.4038/sjdem.v2i1.4336 Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2012; 1 : 46-48
Highlights
Insulinoma is a rare neuroendocrine tumour arising from beta cells of islets of langerhans with an overall incidence of 4 cases per million per year
About 90% of insulinomas are solitary, benign, intrapancreatic and sporadic while up to 10% could be multiple, malignant, extrapancreatic and familial
Diagnosis of insulinoma may be delayed if symptoms are nonspecific
Summary
Insulinoma is a rare neuroendocrine tumour arising from beta cells of islets of langerhans with an overall incidence of 4 cases per million per year. Clinical diagnosis of hypoglycaemia is confirmed with biochemical investigations. Imaging methods are useful in localisation of the insulinoma. Localisation can be difficult as the symptoms usually precede occurrence of a tumour that can be visualised on imaging studies [4,5].
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