title: Misdiagnosis of seizures: insulinoma presenting as adult-onset seizure disorder.
abstract: 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.
authors.affiliation: Department of Endocrinology, Middlesex Hospital, UCLH NHS Trust, London, UK.
authors.forename: T D
authors.initials: TD
authors.lastname: Graves
authors.forename: S
authors.initials: S
authors.lastname: Gandhi
authors.forename: S J M
authors.initials: SJ
authors.lastname: Smith
authors.forename: S M
authors.initials: SM
authors.lastname: Sisodiya
authors.forename: G S
authors.initials: GS
authors.lastname: Conway
mesh_terms: D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D003951:Diagnostic Errors; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D016609:Neoplasms, Second Primary; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000927:Anticonvulsants