[Recurrent seizures of unknown aetiology]

Area of Science:

• Endocrinology
• Oncology

Background:

• A 41-year-old woman presented with confusion and amnesia during a hypoglycemic episode.
• She had a 12-year history of Lamotrigine treatment for seizures of unknown origin.
• Previous investigations for hyperinsulinemia 16 years prior were inconclusive.

Observation:

• The patient experienced recurrent hypoglycemic episodes with confusion and amnesia.
• Continuous intravenous glucose was required to stabilize her clinical state upon presentation.

Findings:

• A pancreatic tumor was detected, exhibiting a two-fold increase in insulin secretion.
• Histopathological examination confirmed the tumor as an insulinoma.

Implications:

• Surgical resection of the insulinoma led to the complete resolution of hypoglycemic episodes and associated symptoms.
• This case underscores the importance of investigating insulinoma in patients with unexplained recurrent hypoglycemia and neurological symptoms.