J Korean Epilepsy Soc.  2004 Dec;8(2):167-170.

Complex Partial Seizure Like Symptoms Presented by a Patient with Insulinoma and Hyperproinsulinemia

• Do YR
• Kwon OD
• Kim JE
• Do JK
• Lee DK

Abstract

Insulinoma with hyperproinsulinemia and normal serum insulin level is a rare disease. Because of the neuroglycopenic symptoms, the initial diagnosis tends to be made as epilepsy or as psychosis. A 43-year-old man was admitted to our hospital because of recurrent confusional episodes. Symptoms are intermittent and consist of staring, confusion, amnesia, and bizarre behavior. Vital signs during the episode were normal but the serum glucose level was 27 mg/dl. The serum level of insulin during the episode was lower than normal and those of proinsulin and growth hormone were higher than normal. Solitary pancreatic mass was found by abdominal CT, measuring 15 mm in diameter. Pathologic evaluation showed islet cell tumor. This suggests that the serum level of proinsulin should be checked when insulinoma with neuroglycopenic symptom is suspected.

Keyword

Insulinoma; Complex partial seizure; Proinsulin

MeSH Terms

Adenoma, Islet Cell
Adult
Amnesia
Blood Glucose
Diagnosis
Epilepsy
Growth Hormone
Humans
Insulin
Insulinoma*
Proinsulin
Psychotic Disorders
Rare Diseases
Seizures*
Tomography, X-Ray Computed
Vital Signs
Growth Hormone
Insulin
Proinsulin