误诊为非惊厥性癫痫持续状态的胰岛素瘤一例

摘要

目的：了解非惊厥性癫痫持续状态（ NCSE ）的误诊原因及胰岛素瘤的诊断及治疗方法。方法分析我院以“非惊厥性癫痫持续状态”收治的1例误诊病例的临床特点。结果胰岛素瘤由于其临床表现多种多样及肿瘤发生的隐蔽性，误诊率较高，部分患者长期被误诊为神经精神系统疾病而延误治疗。该病典型的Whipple三联征表现、胰岛素释放指数增高及胰腺占位性病变对正确诊断有重要作用。结论胰岛素瘤是相对少见的一种胰腺肿瘤，本例貌似非惊厥性癫痫发作为首发症状，因临床表现多样容易误诊，目前手术治疗为首选治疗方法。%Objective To analyze the reasons of misdiagnosis and explore the diagnosis and treatment method of insulinomasM.ethods Describe the characteristics of misdiagnosed case .Rseults As the variety of clinical manifestations , insulinoma easily misdiagnosed to be neuropsychiatric disordes .Whipple triad is the main performance of insulinoma patients , the rate IRI/G is highly sensitive and specific in attack .Before operation , combined CT and MRI can clearly locate the iconography .Conclusion The typical clinical presentation ,thin slice CT scanning and the serum insulin level were the effective measures for the diagnosis for the insulinoma ,and surgery was the treatment of choice and the only curative option for the insulinoma patients .