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Received: 2007-12-20

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Journal of Zhejiang University SCIENCE B 2008 Vol.9 No.6 P.496-499

http://doi.org/10.1631/jzus.B0720011


An insulinoma with clinical and electroencephalographic features resembling complex partial seizures


Author(s):  Shuang WANG, Hai-tao HU, Shu-qun WEN, Zhong-jin WANG, Bao-rong ZHANG, Mei-ping DING

Affiliation(s):  Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   freud_wang@hotmail.com, dingmeiping@tom.com

Key Words:  Insulinoma, Hypoglycemia, Electroencephalography (EEG), Seizure


Shuang WANG, Hai-tao HU, Shu-qun WEN, Zhong-jin WANG, Bao-rong ZHANG, Mei-ping DING. An insulinoma with clinical and electroencephalographic features resembling complex partial seizures[J]. Journal of Zhejiang University Science B, 2008, 9(6): 496-499.

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author="Shuang WANG, Hai-tao HU, Shu-qun WEN, Zhong-jin WANG, Bao-rong ZHANG, Mei-ping DING",
journal="Journal of Zhejiang University Science B",
volume="9",
number="6",
pages="496-499",
year="2008",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0720011"
}

%0 Journal Article
%T An insulinoma with clinical and electroencephalographic features resembling complex partial seizures
%A Shuang WANG
%A Hai-tao HU
%A Shu-qun WEN
%A Zhong-jin WANG
%A Bao-rong ZHANG
%A Mei-ping DING
%J Journal of Zhejiang University SCIENCE B
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%P 496-499
%@ 1673-1581
%D 2008
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0720011

TY - JOUR
T1 - An insulinoma with clinical and electroencephalographic features resembling complex partial seizures
A1 - Shuang WANG
A1 - Hai-tao HU
A1 - Shu-qun WEN
A1 - Zhong-jin WANG
A1 - Bao-rong ZHANG
A1 - Mei-ping DING
J0 - Journal of Zhejiang University Science B
VL - 9
IS - 6
SP - 496
EP - 499
%@ 1673-1581
Y1 - 2008
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0720011


Abstract: 
We described a female patient with insulinoma who experienced recurrent episodes of automatism, confusion and convulsion. Furthermore, her electroencephalography (EEG) findings resembled the pattern in complex partial seizures with secondary generalization. The interictal EEG showed spikes and sharp waves, as well as focal slowing over the left temporal lobe, and the ictal EEG revealed generalized spikes and sharp waves associated with diffused slowing. She was initially misdiagnosed as pharmacoresistant epilepsy. After the insulinoma was found and surgically removed, her EEG turned normal and she was seizure-free during the 4-year follow-up. This report highlights the need for careful reassessment of all seizures refractory to medication, even for the patients associated with epileptiform discharges on EEG.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1] Abdelmalik, P.A., Shannon, P., Yiu, A., Liang, P., Adamchik, Y., Weisspapir, M., Samoilova, M., Burnham, W.M., Carlen, P.L., 2007. Hypoglycemic seizures during transient hypoglycemia exacerbate hippocampal dysfunction. Neurobiol. Dis., 26(3):646-660.

[2] Akanji, A.O., George, A.O., Olasode, B.J., Osotimehin, B.O., 1992. Insulinoma in pregnancy presenting as a seizure disorder: a case report. East. Afr. Med. J., 69(2):117-119.

[3] Bazil, C.W., Pack, A., 2001. Insulinoma presenting as seizure disorder. Neurology, 56(6):817-818.

[4] Dizon, A.M., Kowalyk, S., Hoogwerf, B.J., 1999. Neuroglycopenic and other symptoms in patients with insulinomas. Am. J. Med., 106(3):307-310.

[5] Engel, R., Halberg, F., Tichy, F.Y., Dow, R., 1954. Electrocerebral activity and epileptic attacks at various blood sugar levels with a case report. J. Neural. Transm., 9(1-4):147-167.

[6] Gellhorn, E., Kessler, M., 1942. The effect of hypoglycemia on the electroencephalogram at varying degrees of oxygenation of the blood. Am. J. Physiol., 136:1-6.

[7] Graves, T.D., Gandhi, S., Smith, S.J., Sisodiya, S.M., Conway, G.S., 2004. Misdiagnosis of seizures: insulinoma presenting as adult-onset seizure disorder. J. Neurol. Neurosurg. Psychiatry, 75(8):1091-1092.

[8] Jaladyan, V., Darbinyan, V., 2007. Insulinoma misdiagnosed as juvenile myoclonic epilepsy. Eur. J. Pediatr., 166(5):485-487.

[9] Kirchner, A., Velísková, J., Velísek, L., 2006. Differential effects of low glucose concentrations on seizures and epileptiform activity in vivo and in vitro. Eur. J. Neurosci., 23(6):1512-1522.

[10] McLean, A.M., Fairclough, P.D., 2005. Endoscopic ultrasound in the localisation of pancreatic islet cell tumours. Best Pract. Res. Clin. Endocrinol. Metab., 19(2):177-193.

[11] Mitrakou, A., Fanelli, C., Veneman, T., Perriello, G., Calderone, S., Platanisiotis, D., Rambotti, A., Raptis, S., Brunetti, P., Cryer, P., et al., 1993. Reversibility of unawareness of hypoglycaemia in patients with insulinomas. N. Engl. J. Med., 329(12):834-839.

[12] Noone, T.C., Hosey, J., Firat, Z., Semelka, R.C., 2005. Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract. Res. Clin. Endocrinol. Metab., 19(2):195-211.

[13] Ratcheson, R.A., Blank, A.C., Ferrendelli, J.A., 1981. Regionally selective metabolic effects of hypoglycemia in brain. J. Neurochem., 36(6):1952-1958.

[14] Service, F.J., McMahon, M.M., O'Brien, P.C., Ballard, D.J., 1991. Functioning insulinoma-incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo. Clin. Proc., 66(7):711-719.

[15] Sperling, M.R., 1984. Hypoglycemic activation of focal abnormalities in the EEG of patients considered for temporal lobectomy. Electroencephalogr. Clin. Neurophysiol., 58(6):506-512.

[16] Striano, S., Striano, P., Manganelli, F., Boccella, P., Bruno, R., Santoro, L., Percopo, V., 2003. Distal hypoglycemic neuropathy. An insulinoma-associated case, misdiagnosed as temporal lobe epilepsy. Neurophysiol. Clin., 33(5):223-227.

[17] Tan, N.C., Tan, A.K., Sitoh, Y.Y., Loh, K.C., Leow, M.K., Tjia, H.T., 2002. Paroxysmal exercise-induced dystonia associated with hypoglycaemia induced by an insulinoma. J. Neurol., 249(11):1615-1616.

[18] Tokizane, T., Sawyer, C.H., 1957. Sites of origin of hypoglycemic seizures in the rabbit. Arch. Neurol. Psychiatry, 77(3):259-266.

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