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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.47 no.2 São Paulo June 1989

http://dx.doi.org/10.1590/S0004-282X1989000200017 

Polineuropatia hipoglicêmica: registro de caso com insulinoma

 

Hypoglycemic neuropathy: a case report in association with an insulinoma

 

 

Marcos R. G. De FreitasI; Leila ChimelliII; Osvaldo J. M. NascimentoIII; Gilberto M. BarbosaIV

IDisciplinas de Neurologia e Neuropatologia, Departamentos de Medicina Clínica e de Patologia da Faculdade de Medicina da Universidade Federal Fluminense: Professor Adjunto e Chefe do Serviço de Neurologia
IIDisciplinas de Neurologia e Neuropatologia, Departamentos de Medicina Clínica e de Patologia da Faculdade de Medicina da Universidade Federal Fluminense: Professor Adjunto de Neuropatologia
IIIDisciplinas de Neurologia e Neuropatologia, Departamentos de Medicina Clínica e de Patologia da Faculdade de Medicina da Universidade Federal Fluminense: Professor Adjunto de Neurologia
IVDisciplinas de Neurologia e Neuropatologia, Departamentos de Medicina Clínica e de Patologia da Faculdade de Medicina da Universidade Federal Fluminense: Professor Assistente de Endocrinologia

 

 


RESUMO

Os autores registram o caso de jovem do sexo masculino que desenvolveu polineuropatia sensitivo-motora, com grande amiotrofia das mãos, no curso de crises de. hipoglicemia, provocadas por provável insulinoma. A eletroneuromiografia revelou predominância de alterações axonais. O nervo sural, estudado à microscopia óptica e eletrônica, mostrou perda axonal de fibras mielínicas de grande calibre e de fibras amielínicas. Considerações sobre a etiopatogenia desta síndrome são feitas, parecendo ser devida a hipoglicemia e não a excesso de insulina.


SUMMARY

A case of a young man who presented symptoms and clinical signs of polineuropathy that occurred in connection with recurrent hypoglycemic episodes is reported. The hypoglycemia was probably caused by a pancreatic islet tumor. There were, symmetric weakness and wasting of hands and feet, absent tendon reflexes and 'glove and stocking' loss of sensation. Electromyographic studies showed denervation potentials with slight reduction of nerve conduction velocities. Sural nerve biopsy studied by optic and electronic microscopy showed axonal degeneration without signs of demyelination or remyellnation. There are only 30 similar cases reported in the literature. According to experimental findings, the authors believe that glucopenia is the mechanism responsible for the development of the neuropathy, and that at present time there is no evidence for a direct insulin effect.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

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