Endoscopic ultrasound localization of a solitary insulinoma of pancreatic tail misdiagnosed as epilepsy: case report

[Insulinoma presenting as seizure: case report]

Insulinoma is a rare disease presenting with episodic neuroglycopenic and/or adrenergic symptoms. We describe the case of a 36 year-old female that had been in treatment for complex partial seizures during 4 years without improvement. She presented many crises with marking hypoglycemia. Cranium tomography and electroencephalogram were normal. A 72-hour fast test showed hypoglycemic symptoms with raised insulin and C-peptide. The insulinoma localization was possible during exploratory laparatomy; image methods did not reveal the tumor. Histological findings confirmed an insulinoma. We conclude that blood glucose level should be requested during the investigation of convulsive and behavioral disorders since an insulinoma can present like them.