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Misdiagnosis of seizures: insulinoma presenting as adult-onset seizure disorder
  1. T D Graves1,*,
  2. S Gandhi2,*,
  3. S J M Smith2,
  4. S M Sisodiya2,
  5. G S Conway1
  1. 1Department of Endocrinology, Middlesex Hospital, UCLH NHS Trust, London, W1A 8NN, UK
  2. 2National Society for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
  1. Correspondence to:
 Sanjay Sisodiya
 National Society for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK;


Once diagnosed with a refractory seizure disorder, patients often receive aggressive and escalating pharmacotherapy. However, a significant proportion of patients referred to neurologists do not have epilepsy. Toxic and metabolic causes of seizures should always be considered as they are potentially curable, and may be fatal if untreated. The following case report highlights the need for careful reassessment of all seizures that are atypical and refractory to medication.

  • epilepsy
  • hypoglycaemia
  • insulinoma

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  • * These authors contributed equally to this paper

  • Competing interests: none declared