![]() When the relationship between symptoms and possible hypoglycemia is missed, in most clinical settings, the blood glucose levels are not be checked. ![]() Clinical clues suggest that insulinoma continues to be diagnosed based on the physician’s recognition of the presence of hypoglycemic symptoms, such as sweating, hunger, tremors, and palpitations. It is also the most common cause of hypoglycemia associated with endogenous hyperinsulinemia ( Marks, 1971). Insulinoma is a very rare neuroendocrine tumor with a reported incidence of 0.5–5 per million person-years. This case emphasizes the need for careful reassessment of all atypical and refractory seizures for neurologists. The appearance of unusual manifestations and insulinoma imaging makes it difficult to accurately diagnose the condition. A starvation test, pancreatic enhancement CT, MRI scan, and pathological examination clinically diagnosed insulinoma, and the symptoms improved following surgical removal of the tumor. During this period, the patient continued to suffer from repeated seizures. In this study, a 64-year-old man presented with intermittent seizure episodes after being misdiagnosed with epilepsy and receiving anti-epileptic drugs for 4 years. ![]() Department of Neurology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Chinaĭelayed diagnosis of insulinoma remains an intractable clinical challenge because the symptoms are in most cases misattributed to other disorders.Ziyou Qi †, Daojing Li †, Jinfeng Ma, Peng Xu, Yongnan Hao and Aimei Zhang *
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