Insulinoma Masquerading as Transient Neurocognitive Impairment

A 55-year-old man presented with 6 months of increasingly frequent episodes of confusion and abnormal behavior (Video 1). Neurologic examination and diagnostic work-up were unremarkable. He was evaluated for stroke, Huntington's disease, conversion disorder, and other neuropsychiatric conditions without a satisfactory diagnosis. Months later, he suffered another episode and was found to have a glucose of 33mg/dL. This improved with glucose administration but rapidly dropped to 30mg/dL. A 72-hour fast, which revealed a low serum glucose and elevated insulin, pro-insulin, and C-peptide levels, strongly suggested the diagnosis of insulinoma.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research