精神病院中所见的胰岛素瘤

Psychiatric presentation of insulinoma

对精神科少见的胰岛素瘤１３例进行临床分析。发现这些病人起病均有诱因，而且负性精神因素较多见，均伴有意识障碍，这些病例均被误诊为功能性精神病、癫痫及脑炎等。

Objective:To describe cases of insulinoma presenting to psychiatric setting and discuss the clinical features and differential diagnoses.Method:Clinical history of 13 cases of insulinoma presenting to this department of psychiatry was reviewed retrospectively.Results:Precipitating factors and impairedconscious level were common findings at the onset of illness.They were misdiagnosed as functional psychoses,epilepsy and encephalitis.Discussion:Insulinoma are easily misdiagnosed.The common pitfalls are 1)psychiatrists not familiar with the clinical features of insulinoma 2)biased towards mental symptoms 3)diagnosing epilepsy or encephalitis in view of abnormal EEG finding 4)considering change in mental state not corresponding to blood glucose level as atypical.