title: Hypoglycemic encephalopathy as the initial presentation of hepatic tumor: a case report.
abstract: BACKGROUND
  Hypoglycemia is a frequently encountered cause of altered mental status in clinical practice.
  
  
  OBJECTIVE
  To report a rare case with hypoglycemia-induced coma as the sole and initial clinical manifestation of a hepatic tumor.
  
  
  METHODS
  A previously healthy 32-year-old man presenting with acute change in consciousness was found to have hepatoma related hypoglycemia.
  
  
  CONCLUSIONS
  This case highlights the importance of a hepatic evaluation in, otherwise, unexplained hypoglycemic coma in high prevalence areas of hepatocellular carcinoma such as the Asian-Pacific region.
authors.affiliation: Department of Neurology, Skin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Chi-Ieong
authors.initials: CI
authors.lastname: Lau
authors.forename: Han-Cheng
authors.initials: HC
authors.lastname: Wang
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Hsu
mesh_terms: D000328:Adult; D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D001928:Brain Diseases, Metabolic / Q000209:etiology* / Q000503:physiopathology*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000000981:diagnostic imaging / Q000821:virology; D005947:Glucose / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications / Q000208:ethnology; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000821:virology; D008297:Male; D011379:Prognosis; D013624:Taiwan / Q000453:epidemiology / Q000208:ethnology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D001786:Blood Glucose; D005947:Glucose