Insulinoma presenting as complex partial seizures

Abstract

We describe a 42-year-old male patient who presented with recurrent left focal seizures with altered sensorium refractory to polytherapy with antiepileptic drugs and recurrent hypoglycemic episodes. Whipple's triad was documented. Insulin, C-peptide levels were elevated, and insulin-glucose ratio was more than 0.3 confirming the endogenous hyperinsulinism. Magnetic resonance imaging (MRI) abdomen revealed mass in the tail and distal body of the pancreas. Interictal electroencephalography showed generalized slow wave activity in delta range. MRI brain was normal. Excision of tumor was done. Histopathology confirmed the insulinoma. The patient had no recurrence of seizures during follow-up.

Keywords

• electroencephalography
• endogenous hyperinsulinism
• hypoglycemia
• seizures