胰岛素瘤误诊为癫痫4例并文献复习

Report of 4 Cases of Insulinoma Misdiagnosed as Epilepsy and Literature Review

目的:提高对胰岛索瘤的认识.减少误诊误治。方法:对4例胰岛素瘤作回顾性研究,分析其误诊误治的原因并探讨对策。结果:4例均曾被误诊为癫痫,其中1例还曾被误诊为脑血管病、精神分裂症等长达12a而恶变失去手术机会。4例均在我院根据Whipple三联征获得确诊。结论:胰岛索瘤发病率低,其临床特征与癫痫相似而常导致误诊误治。加强对胰岛索瘤的认识,仔细分析病史,是正确诊断和治疗的关键。

Objective:To improve the understanding of insulinoma and to avoid misdiagnosis. Methods;Clinical data of four patients with insulinoma were analyzed retrospectively. Results: All four patients were misdiagnosed as epilepsy.one of which had even been misdiagnosed as cerebrovascular disease and schizophrenia for 12 years so that the operative opportunity was lost. All four patients were diagnosed correctively as insulinoma according to trilogy of Whipple in our hospital. Conclusion:The incidence of insulinoma was very low. Its clinical features were similar to those of epilepsy. Hence it was easdy rmsdiagnosed. The improvement of the understanding of insulinoma. and careful analysis of medical history, were the keys to correct diagnosis and management.