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A hypoglycaemic 'Peter Pan': a paediatric disease in an adult patient?

Shannon McCarthy, Mark Kotowicz

    Endocrinology, Diabetes & Metabolism Case Reports
    |June 14, 2025
    PubMed

    Insights

    A 56-year-old male with a history of seizures experienced resolution of his condition after treatment for hyperinsulinaemic hypoglycaemia caused by pancreatic nesidioblastosis. This case highlights the importance of blood glucose monitoring in seizure patients.

    Area of Science:

    • Endocrinology
    • Neurology
    • Pathology

    Background:

    • A 56-year-old male with cerebral palsy and intractable generalized tonic-clonic seizures (GTCS) presented with vomiting.
    • His medical history included lifelong GTCS despite anticonvulsant therapy.

    Purpose of the Study:

    • To investigate the cause of seizures in a patient with previously uncontrolled epilepsy.
    • To determine the link between metabolic derangements and neurological symptoms.

    Main Methods:

    • Clinical presentation and medical history review.
    • Capillary blood glucose measurement during a seizure.
    • Diagnostic investigations for hyperinsulinaemic hypoglycaemia.
    • Management of nesidioblastosis and monitoring of glycaemic control.

    Main Results:

    • A capillary blood glucose of 1.6 mmol/L was recorded during a seizure.
    • Investigations confirmed hyperinsulinaemic hypoglycaemia secondary to diffuse pancreatic nesidioblastosis.
    • Seizure disorder resolved completely with consistent normoglycaemia achieved through nesidioblastosis management.

    Conclusions:

    • Unrecognised hyperinsulinaemic hypoglycaemia can manifest as intractable seizures.
    • Diffuse pancreatic nesidioblastosis is a potential cause of hyperinsulinaemic hypoglycaemia in adults.
    • Achieving normoglycaemia is crucial for resolving seizure disorders associated with hyperinsulinaemic hypoglycaemia.
    Abstract

    Keywords:
    Paediatric endocrinologyhypoglycaemiapancreatic disease

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