A CASE is reported in which prolonged hypoglycemia due to an islet cell tumor of the pancreas was accompanied with an unusual array of symptoms due to widespread damage of the central nervous system. The patient had had repeated convulsions, periods of confusion and excitement, ataxia, muscular atrophy, intellectual impairment and pseudologia fantastica. After removal of the pancreatic adenoma, all abnormalities except the muscular atrophy disappeared. It has been recognized that deprivation of glucose essential for metabolism of the nerve cells can cause irreversible damage of the brain and spinal cord, but involvement of the central nervous system as extensive as in the present case has rarely been reported. Both the relationship of a syndrome resembling progressive muscular atrophy to spontaneous hypoglycemia and the recovery of a patient with pseudologia fantastica seem of unusual interest.
REPORT OF A CASE
The patient, a 23 year old veteran, came to our attention