title: An unusual cause of reversible axonal neuropathy and hypertension in a 10-year-old girl.
abstract: A 10-year-old girl, who was referred with refractory epilepsy, had 1.5 years of episodic abnormal behavior. On examination, she also had hypertension and peripheral neuropathy. Hypoglycemia with correspondingly high insulin levels was documented during a confusional episode. MRI of the abdomen revealed an islet cell tumor in the body of the pancreas. One year after tumor excision, both the neuropathy and hypertension showed remarkable improvement. A final diagnosis of insulinoma with hypoglycemic axonal neuropathy and hypertension (reversed with tumor excision) was made. Insulinoma is the commonest cause of hyperinsulinemic hypoglycemia in adults, but is rare in childhood. To our knowledge, distal symmetrical motor-sensory axonal neuropathy has been described in only 40 patients, and hypertension has not been reported with insulinoma.
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. kaulbhavna@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Kaul
authors.forename: P
authors.initials: P
authors.lastname: Kaur
authors.forename: M
authors.initials: M
authors.lastname: Tripathi
authors.forename: R
authors.initials: R
authors.lastname: Khadgawat
authors.forename: A C
authors.initials: AC
authors.lastname: Ammini
authors.forename: S
authors.initials: S
authors.lastname: Agarwala
authors.forename: S
authors.initials: S
authors.lastname: Kaushal
authors.forename: S
authors.initials: S
authors.lastname: Dattagupta
mesh_terms: D002648:Child; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000209:etiology; D007340:Insulinoma / Q000150:complications; D008279:Magnetic Resonance Imaging; D010190:Pancreatic Neoplasms / Q000150:complications; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000209:etiology