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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Insulinoma is a rare disease, which frequently causes hypoglycemic symptoms and signs or even shock. However, other diseases that produce similar symptoms and signs should firstly be ruled out. We describe a 63 years old male veteran who suffered from repeated episodes of seizure and conscious disturbance upon fasting, on and off for 8 years. Serial examinations led to the suspicion that this might be a case of insulinoma; the suspicion was later confirmed by pathologic examination after the tumor had been excised, and his problems disappeared. After six years, a follow-up examination showed that his condition was still stable.
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PMID:Insulinoma: a case report. 187 60

Insulinoma was diagnosed in a 7-year-old female ferret examined because of generalized seizures, intermittent paraplegia, and abnormal behavior. Low serum glucose, high serum insulin, and infinite amended insulin/glucose ratio values in this ferret supported the clinical diagnosis of insulinoma. Histologic examination of the pancreas confirmed the diagnosis of insulinoma. The clinical signs and laboratory evaluations in this case and in a previously reported case of insulinoma in a ferret were consistent with variations reported in dogs with insulinoma.
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PMID:Insulinoma in a ferret. 302 97

Digestive neuro-endocrine tumours have a broad and initially misleading clinical spectrum. Tumours from the duodenopancreatic area should be distinguished from digestive carcinoid tumours. In the first group, insulinomas, gastrinomas, and non-functioning tumours are the most frequent. Insulinoma is responsible for hypoglycaemic symptoms (coma, confusion, seizure, psychiatric disorders) associated with adrenergic response (sweat, tachycardia, palpitations). Gastrinoma is responsible for the Zollinger-Ellison syndrome, which associates peptic ulcers in the oesophagus, stomach, and duodenum without Helicobacter pylori infection, and chronic volumogenic diarrhoea. Non-functioning tumours are recognised fortuitously or at a late stage, when large tumour mass contrasts with often unaltered general condition. Carcinoid tumours are mainly located in the appendix, the rectum, and the small bowel. In the 2 first conditions, the diagnosis is most often made on a resection specimen after uneventful appendectomy or polypectomy; in the latter, the carcinoid syndrome is frequent, combining cutaneous flushing, motor diarrhoea, tricuspid valve insufficiency and bronchospasm.
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PMID:[Clinical spectrum of digestive neuroendocrine tumors]. 1192 15

An Afghan hound was presented with recurring episodes of weakness progressing to seizures after exercise. Insulinoma was diagnosed by demonstrating excessive insulin secretion in the presence of hypoglycemia. A pancreatic mass was identified and removed during an exploratory laparotomy. Surgical and pathological findings, diagnosis, and clinical management are discussed.
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PMID:Pancreatic insulin-secreting neoplasia in a 9-year-old Afghan hound. 1466 55

Insulinoma tumors are often difficult to detect, as the symptoms largely precede occurrence of a visualized tumor. We report the case of an insulinoma patient with long delayed diagnosis and marked adaptation to extreme hypoglycemia. The patient with a 7-yr history of seizures was found to have plasma glucose concentration during a starvation test as low as 16 mg/dl, with no clinically significant symptoms and concomitant normal plasma insulin levels: 10-30 microIU/ml. All attempts to localize a tumor with repeated abdominal ultrasound examinations or computed tomography scanning were unsuccessful. The patient did not tolerate the introduced oral treatment with diazoxide. Once it had become technically available, endoscopic ultrasonography of the pancreas was performed. It revealed a 10 mm tumor in the pancreatic head. The tumor was subsequently removed surgically. During the operation plasma insulin concentration rose almost 15-fold, which confirmed the insulin-secreting character of the growth. Microscopic examination revealed benign insulinoma, with partially trabecular structure. One month after the operation the patient had normal plasma glucose values of 60-120 mg/dl, but she constantly complained of excessive thirst, which occurred soon after the operation and slowly subsided in the following weeks. In conclusion, the present report demonstrates that insulinoma should be considered and searched for in every case of hypoglycemia associated with normal insulin levels. It also confirms the essential role of endoscopic ultrasonography in the diagnosis of insulin-secreting tumors.
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PMID:Diagnostic difficulties in long-standing insulinoma with near-normal plasma insulin levels. 1588 65

Clinical history and inappropriate insulin secretion during hypoglycemic episodes permit the diagnosis of hyperinsulinism. We report 2 cases of factitious hyperinsulinism leading to partial pancreatectomy. Case 1 was an 8-year-old girl who presented with severe hypoglycemia and elevated insulin and C-peptide levels. Catheterization of pancreatic veins was performed to localize the excess insulin secretion. Insulinoma was suspected, and partial pancreatectomy was performed. Ten days after surgery, severe hypoglycemia recurred with severely elevated plasma insulin levels (x100) but very low C-peptide plasma levels, suggesting factitious hyperinsulinemia. Hypoglycemic episodes before surgery were provoked by oral sulfonamides; postoperative episodes were caused by parenteral insulin. Falsified prescriptions for sulfonamides and insulin by the mother, a nurse, were found. Case 2 was a 6-month-old girl who presented with seizures and hypoglycemia but had a symptom-free interval of many months afterward. At 2 years of age, repeated hypoglycemic seizures and elevated insulin plasma levels suggested congenital hyperinsulinism. C-peptide plasma level, measured once, was normal, but blood sampling was performed 15 minutes after a hypoglycemic episode. Partial pancreatectomy was performed. Two weeks after surgery, hypoglycemic seizures recurred, and the patient was admitted for pancreatic vein catheterization. This investigation was performed during hypoglycemia and revealed high insulin levels and undetectable C-peptide levels, suggesting factitious hypoglycemia. Insulin/C-peptide ratio analysis is crucial to assess factitious hypoglycemia, although sulfonamide-induced hypoglycemia is not thereby detected. One percent (2 of 250) of all cases of hyperinsulinemic hypoglycemia in our unit have been identified as Munchausen syndrome by proxy. Atypical disease history should raise the question of factitious hypoglycemia.
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PMID:Factitious hyperinsulinism leading to pancreatectomy: severe forms of Munchausen syndrome by proxy. 1599 15

Insulinoma is a very rare pancreatic neoplasm of childhood. Early recognition of insulinoma is important to ensure proper surgical treatment and prevent serious adverse neurological consequences. We describe here a case of insulinoma in an infant who presented with seizures and abnormal behaviour. Random blood glucose was found to be abnormally low (40 mg/dl). MRI showed a well-encapsulated mass (hypointense on T1-weighted and hyperintense on T2-weighted images) at the junction of the head and body of the pancreas. The tumour was successfully enucleated. Histopathology confirmed the diagnosis of insulinoma.
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PMID:MR imaging appearance of insulinoma in an infant. 1740 23

Insulinoma is a common cause of seizures due to recurrent hypoglycemic crises. Surgical treatment usually results in disappearance of such seizures. We describe a previously healthy 17 year-old girl who became epileptic after the onset of insulinoma with persistent seizures after surgical removal of the tumour. Insulinoma must be taken into account for differential diagnosis with convulsions of unknown origin, and even after metabolic normalization it may cause epilepsy.
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PMID:Can insulinoma cause generalised epilepsy? 1784 47

Insulinoma in children and adolescents is extremely rare. In adults diagnosis is frequently delayed due to frequent neuropsychiatric symptoms that are misunderstood. Diagnostic localization is sometimes extremely difficult. We present a case of insulinoma with onset of symptoms at the age of 12.5 years. Diagnosis was made very soon after the first symptoms, but diagnostic localization was delayed, since conventional MRI did not reveal the insulinoma. The patient suffered from recurrent hypoglycemic seizures and gained 54 kg in weight until diagnostic localization was made with abdominal MRI, octreotate-PET and finally successful endosonography. A solitary insulinoma in the pancreatic tail was enucleated laparoscopically.
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PMID:Recurrent hypoglycemic seizures and obesity: delayed diagnosis of an insulinoma in a 15 year-old boy--final diagnostic localization with endosonography. 1803 12

Insulinoma is the most frequent endocrine tumour of the pancreas derived from the beta cells which, while retaining the ability to synthesise and secrete insulin, is autonomous from the normal feedback mechanisms. The characteristic clinical manifestation of this neoplasm is fasting hypoglycaemia, with sympathoadrenal and neuroglycopenic symptoms. In extremely rare cases insulinoma can be a cause of acute coronary syndrome. Surgical removal is the treatment of choice and recurrences are uncommon. We report a case of a 74-year-old man with acute coronary syndrome caused by adrenergic stimulation during severe hypoglycaemic seizures in the course of insulinoma.
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PMID:[Acute coronary syndrome induced by hypoglycemia in the course of insulinoma--a case report]. 1826 88


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