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Insulinoma as a cause of seizure-like activity and spontaneous hypoglycaemia
  1. Fahd Fayyaz1,
  2. Michael Francis Reardon1 and
  3. Luke Byrne2
  1. 1Medicine, Wexford General Hospital, Wexford, Ireland
  2. 2Cardiology, Tallaght University Hospital, Dublin, Ireland
  1. Correspondence to Dr Fahd Fayyaz; fahdfayyaz{at}


A woman in her 60s presented to our hospital with recurrent episodes of confusion and double vision with spontaneous recovery to baseline within 10 min. Her initial workup was unremarkable, and she was diagnosed with complex partial seizures and commenced on levetiracetam. The following week, she re-presented with a recurrence of her symptoms, associated with spontaneous hypoglycaemia, with blood glucose levels of 1.9 mmol/L. She was found to have endogenously elevated serum insulin and C peptide levels, which were concomitantly associated with hypoglycaemia. An initial diagnosis of insulinoma was made and she was commenced on diazoxide. MRI and endoscopic ultrasound revealed 16 mm insulinoma in her uncinate process. She underwent surgical resection and remained symptom free at follow-up. This case highlights the importance of blood glucose measurements in patients presenting with neuroglycopenic symptoms and outlines the workup and management of insulinoma.

  • Endocrinology
  • Drugs: endocrine system
  • Epilepsy and seizures

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  • Contributors FF authored this case study and this was coauthored by LB. MFR proofread the case study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.