Central European Annals of Clinical Research

(ISSN: 2668-7305) Open Access Journal
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Central European Annals of Clinical Research (CEACR) is no longer published on JAMS (the publishing platform provided by MDPI) as of 10.07.2021. The articles published until that date are archived at ceacr.archive.jams.pub by courtesy of JAMS.

Cent_Eur_Ann_Clin_Res 2020, 2(1), 50; doi:10.35995/ceacr2010050

Endoped Abstract
Seizures, Metabolic or Neurologic Cause?
Alexandra Grozavu 1,*, Meda Bugi 1,2, Giorgiana Brad 1,2, Otilia Mărginean 1,2 and Monica Mărăzan 1
Clinic I Pediatrics, Emergency Hospital for Children “Louis Țurcanu”, 300011 Timișoara, Romania; nutritiapentrutoti@gmail.com (M.B.); brad.giorgiana@umft.ro (G.B.); marginean.otilia@umft.ro (O.M.); marazanmonica@yahoo.co.uk (M.M.)
“Victor Babeș” University of Medicine and Pharmacy, Faculty of Medicine, Timișoara, Romania
Corresponding author: grozavu.alexandra@yahoo.ro
How to cite: Grozavu, A.; Bugi, M.; Brad, G.; Mărginean, O.; Mărăzan, M. Seizures, Metabolic or Neurologic Cause? Cent. Eur. Ann. Clin. Res. 2020, 2(1), 50; doi:10.35995/ceacr2010050.
Received: 26 October 2020 / Accepted: 14 November 2020 / Published: 17 November 2020
child; hypoglycemia; insulinoma; seizures

Background and Aims

Insulinoma is the most frequent cause of organic hypoglycemia. In 90% of cases [1], it is a benign pancreatic tumor, which secretes insulin [2]. The aim of this clinical case presentation is to highlight the need for early diagnosis of organic hypoglycemia in the prevention of neurological damage [3].

Material and Methods

We present the clinical case of a 13-year-old patient. An assessment was made of the patient’s history, clinical examination, paraclinical investigations and interdisciplinary consults.


A 13-year-old patient, with obesity and recurrent headaches for more than one month, presented a short-term tonic-clonic seizure with spontaneous recovery, followed by postcritical drowsiness. The blood sample taken after this episode showed low plasma glucose of 55 mg/dL. The glycemia was monitored and several episodes with neuroglycopenic symptoms (headache and aggressive behavior) were detected, with glucose levels between 35 and 120 mg/dL during the day. A neurological cause of the seizure episode was excluded by performing an EEG and head CT. Blood analysis revealed a serum glucose level of 66 mg/dL, with an insulinemia of 77.26 μIU/mL, value which suggested the probability of insulinoma, which was confirmed by an abdominal MRI. The treatment of choice for insulinoma is surgical excision [4,5]. Medical management until the surgical procedure consisted of the prevention of hypoglycemia by ingesting long-acting carbohydrates every 3 h, alternating with 10% glucose administered intravenously during the night, associated with anticonvulsant treatment.


In recurrent cases of moderate or severe hypoglycemia with neuroglycopenic symptoms, we should consider an organic cause. A simple venous/capillary blood determination of glucose can guide us in a correct diagnosis.


This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.


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