Temporal Lobe Epilepsy by Insulinoma: A Case of Persistent Abnormalities in Post-Operative EEG / 신경정신의학

ABSTRACT

Authors experienced a case of insulinoma which was initially misdiagnosed as idopathic temporal lobe epilepsy with automatism. This patients did not show other hypoglycemic symptoms except seizure. It has been reported that some of the patients with insulinoma are unaware of hypoglycemia and are at increased risk for seizures and coma. These patients would have normal glucose uptake in the brain and consequently no sympathoadrenal activation would begin, resulting in an awareness of hypoglycemia. It this case, abnomal EEG pattern consistent with a complex partial seizure remained after successful operation. Recent reports indicate that hypoglycemia is capable of killing neurons in the brain. An endogenous neurotoxin is produced and is released by the brain into tissue and cere-brospinal fluid. Endogenous excitotoxins produced during hypoglycemia may explain the tendency toward seizure activity often seen clinically. We suggest that persistent abnormalities of EEG in this case may be related to focal neuronal damage in hypoglycemia.