Acta Neurologica Belgica

, Volume 119, Issue 4, pp 653–655 | Cite as

Super refractory status epilepticus in a patient with insulinoma

  • Surjya P. Choudhury
  • Deepanshu Dubey
  • Jayantee Kalita
  • Usha K. MisraEmail author
Letter to the Editor

Dear Sir,

Hypoglycemia is a medical emergency which presents with behavioural abnormality, altered sensorium and seizures. In the developing countries because of poor health infrastructure and delayed treatment, seizures may become refractory to treatment. We report a patient with super refractory status epilepticus (SRSE) due to insulinoma and emphasise the importance of following treatment guidelines of management of status epilepticus (SE).

Case report

A 13 years old girl developed generalised tonic–clonic convulsions during sleep. She was treated with IV diazepam, phenytoin and midazolam. Since the seizures did not respond for 30 h, she was referred to our hospital. She was comatose, febrile, dehydrated, with her heart rate was 128/min and blood pressure 80/60 mmHg. She was having generalised tonic–clonic seizure. Her blood sugar was 34 mg/dl which was treated with 25% dextrose. Her seizures stopped within half an hour. She also had seizures 3 and 9 months back for which she was...



We thank Mr. Shakti Kumar for secretarial help.



Compliance with ethical standards

Conflict of interest

There is no conflict of interest to declare.


  1. 1.
    Shah PA, Malik HA, Bhat HM, Basu JA (2013) Insulinoma masquerading as status epilepticus. Internet J Neurol 16(1)Google Scholar
  2. 2.
    O’Sullivan Sean Stephen, Redmond J (2005) Insulinoma presenting as refractory late-onset epilepsy. Epilepsia 46(10):1690–1691CrossRefGoogle Scholar
  3. 3.
    Dizon AM, Kowalyk S, Hoogwerf BJ (1999) Neuroglycopenic and other symptoms in patients with insulinomas. Am J Med 106:307CrossRefGoogle Scholar
  4. 4.
    Schmidt P, Böttcher J, Ragoschke-Schumm A, Mentzel HJ, Wolf G, Müller UA, Kaiser WA, Mayer TE, Saemann A (2011) Diffusion-weighted imaging of hyperacute cerebral hypoglycemia. Am J Neuroradiol 32(7):1321–1327CrossRefGoogle Scholar
  5. 5.
    Ma JH, Kim YJ, Yoo WJ, Ihn YK, Kim JY, Song HH et al (2009) MR imaging of hypoglycemic encephalopathy: lesion distribution and prognosis prediction by diffusion-weighted imaging. Neuroradiology 51:641–649CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Department of NeurologySanjay Gandhi Post Graduate Institute of Medical SciencesLucknowIndia

Personalised recommendations