복합부분발작의 양상을 보이고 고프로인슐린혈증을 보인 인슐린종 1예
Complex Partial Seizure Like Symptoms Presented by a Patient with Insulinoma and Hyperproinsulinemia
도영록, 권오대, 김지은, 도진국, 이동국,
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도영록 ( Do Young-Rok )
대구가톨릭대학교 의과대학 신경과학교실
권오대 ( Kwon Oh-Dae )
대구가톨릭대학교 의과대학 신경과학교실
김지은 ( Kim Ji-Eun )
대구가톨릭대학교 의과대학 신경과학교실
도진국 ( Do Jin-Kuk )
대구가톨릭대학교 의과대학 신경과학교실
이동국 ( Lee Dong-Kuck )
대구가톨릭대학교 의과대학 신경과학교실
KMID : 0877220040080020167
Abstract
Insulinoma with hyperproinsulinemia and normal serum insulin level is a rare disease. Because of the neuroglycopenic symptoms, the initial diagnosis tends to be made as epilepsy or as psychosis. A 43-year old man was admitted to our hospital because of recurrent confusional episodes. Symptoms are intermittent and consist of staring, confusion, amnesia, and bizarre behavior. Vital signs during the episode were normal but the serum glucose level was 27 mg/dl. The serum level of insulin during the episode was lower than normal and those of proinsulin and growth hormone were higher than normal. Solitary pancreatic mass was found by abdominal CT, measuring 15 mm in diameter. Pathologic evaluation showed islet cell tumor. This suggests that the serum level of proinsulin should be checked when insulinoma with neuroglycopenic symptom is suspected.
키워드
Insulinoma;Complex partial seizure;Proinsulin
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