Insulinoma misdiagnosed as intractable epilepsy
Bibliographic record
Abstract
Many conditions may mimic epileptic seizures, including movement disorders, cardiac arrhythmias, psychiatric disorders, or metabolic anomalies. Among these, insulinoma is a rare but curable cause of hypoglycemia often misdiagnosed as epilepsy or a psychiatric disorder. We report three patients with hypoglycemic spells caused by insulinoma. All patients were diagnosed during a video-EEG monitoring session initially performed for the evaluation of intractable epilepsy. ### Case 1. A 37-year-old woman had a 6-year history of stereotyped paroxysmal episodes of paresthesias of the left arm, spreading to the face and lower limbs, and lasting 20 minutes. Episodes could last up to 2 hours and included gait incoordination, mild agitation, emotional lability, and incoherent speech, which was followed by fatigue. Frequency of the attacks gradually increased up to twice a week. The patient was initially diagnosed with partial epilepsy, refractory to carbamazepine. No interictal activity was recorded during a prolonged video-EEG monitoring. Brain MRI was normal, and interictal SPECT revealed bifrontal and right posterior temporal hypoperfusion. A fasting blood glucose level was obtained and showed mild hypoglycemia at 3.2 mmol/L (normal, 3.8 to 6.1 mmol/L). …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".