Misleading features of neuroimaging and electroencephalography: insulinoma misdiagnosed as temporal lobe epilepsy.
Epileptic Disorders. 2013-03-01; 15(1): 93-97
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1. Epileptic Disord. 2013 Mar;15(1):93-7. doi: 10.1684/epd.2013.0556.
Misleading features of neuroimaging and electroencephalography: insulinoma
misdiagnosed as temporal lobe epilepsy.
Aupy J(1), Benoilid A, Sarhan M, Dalvit C, Valenti MP, Hirsch E.
(1)Département de Neurologie, Hôpital Universitaire de Strasbourg, Strasbourg,
Epilepsy is a common disorder but diagnosis remains largely clinical. Although
MRI and EEG significantly aid the diagnosis of epilepsy, these techniques may
also be misleading and indicate abnormalities not related to phenomenology.
Consequences of erroneous diagnosis of epilepsy may lead to aggressive and
escalating pharmacotherapy with potentially serious side effects. Metabolic
disorders, which may mimic epilepsy, should always be considered as they are
potentially curable and may be fatal if untreated. We report a case of an
insulinoma, misdiagnosed as temporal lobe epilepsy. We highlight the risks
associated with misinterpretation of neuroimaging and EEG and outline an approach
to differentiate between symptoms of insulinoma or neuroglycopenia and temporal
PMID: 23531631 [Indexed for MEDLINE]