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INSULIN HYPOGLYCEMIA IN EPILEPSY

INSULIN HYPOGLYCEMIA IN EPILEPSY Abstract In this study epileptic patients were given injections of insulin for the purpose of determining the rôle of hypoglycemia in precipitating seizures. Reports of many studies have appeared in the literature suggesting that epileptic attacks may be due to hypoglycemia. On the whole, the evidence has been indirect and not conclusive. Recent clinical knowledge of hyperinsulinism and other types of hypoglycemia has aroused attention anew to this problem. Harris1 reported three cases of hyperinsulinism and collected reports of twelve others (twelve of fifty recorded cases) in which convulsions were the predominant symptom. In several of these cases a diagnosis of epilepsy was made at first. The injection of insulin is known to induce convulsions in several species of animals. In fact, insulin was formerly assayed in rabbits by this method. Convulsions resulting from an overdose of insulin are of infrequent occurrence in adult human beings. Still, if hypoglycemia bears References 1. Harris, S.: Epilepsy and Narcolepsy Associated with Hyperinsulinism: Report of Three Cases of Epilepsy and of One Case of Narcolepsy Cured Clinically by Partial Resection of Body and Tail of Pancreas , J. A. M. A. 100:321 ( (Feb. 4) ) 1933.Crossref 2. Moracci, E.: Concerning Convulsions in Pigeons Arising from Substances Lowering the Blood Sugar: I. Investigation of the Factors Determining the Onset of Convulsions , Boll. d. Soc. ital. di biol. sper. 7:302, 1932. 3. Drabkin, D. L., and Shilkret, H.: Insulin Anhydremia: Importance of the Water-Reserve in a Physiologic Crisis , Am. J. Physiol. 83:141 ( (Dec.) ) 1927. 4. Benedict, S. R.: The Estimation of Sugar in Blood and Normal Urine , J. Biol. Chem. 68:759 ( (June) ) 1926. 5. Campbell, W. R., and Macleod, J. J. R.: Insulin , Medicine 3:195 ( (Aug.) ) 1924.Crossref 6. Voegtlin, C.: The Biological Standardization of Insulin: II. The Mortality and Glucose-Protective Test in Rats as a Method for the Bio-Assay of Insulin , Pub. Health Rep. 39:1935, 1924.Crossref 7. Griffith, J. P. C.: Hypoglycemia and the Convulsions of Early Life , J. A. M. A. 93:1526 ( (Nov. 16) ) 1929.Crossref 8. Frazier, C. H.: Pituitary Cachexia , Arch. Neurol. & Psychiat. 21:18 ( (Jan.) ) 1929. 9. Calder, R. M.: Anterior Pituitary Insufficiency (Simmond's Disease) , Bull. Johns Hopkins Hosp. 50:87 ( (Feb.) ) 1932. 10. Silver, S.: Simmond's Disease (Cachexia Hypophyseopriva): Report of a Case with Postmortem Observations and a Review of the Literature , Arch. Int. Med. 51:175 ( (Feb.) ) 1933. 11. Osler, W., and McCrae, T.: The Principles and Practice of Medicine , ed. 9, New York, D. Appleton & Co., 1922, p. 867. 12. Hartman, F. A.; Brownell, K. A., and Crosby, A. A.: The Relation of Cortin to the Maintenance of Body Temperature , Am. J. Physiol. 98:674 ( (Nov.) ) 1931. 13. Reismann, D.: Diseases of the Adrenal Glands , in Christian, H. A., and Mackenzie, J.: Oxford Medicine , New York, Oxford University Press, 1926, vol. 3, p. 784. 14. Mann, F. C.: Studies in the Physiology of the Liver: I. Technic and General Effects of Removal , Am. J. M. Sc. 161:37, 1921. 15. Baudouin, A.; Azerad, E., and Lewin, J.: Test of Hypoglycemia Produced by Insulin in Epileptics: Seventeen Cases , Compt. rend. Soc. de biol. 114: 902, 1933. 16. Labbé, M., and Escalier, A.: Disturbance of the Carbohydrate Regulation in Epileptics , Médecine 13:485 ( (July) ) 1932. 17. Pagniez, P.: Question of Existence of Epilepsy Due to Hypoglycemia , Presse méd. 41:876 ( (May 31) ) 1933. 18. Elias, H., and Goldstein, J.: Insulin Shock and the Central Nervous System: Insulin in the Focal Diagnosis of Cerebral Pathology , Med. Klin. 28:542 ( (April 15) ) 1932. 19. Lennox, W. G., and Cobb, S.: Epilepsy from the Standpoint of Physiology and Treatment , Baltimore, Williams & Wilkins Company, 1928. 20. Hrubetz, M. D.: Assay of Insulin and Blood Sugar Level , Am. J. Physiol. 107:284 ( (Feb.) ) 1934. 21. Harris, S.: Hyperinsulinism, a Definite Disease Entity: Etiology, Pathology, Symptoms, Diagnosis, Prognosis and Treatment of Spontaneous Insulinogenic Hypoglycemia , J. A. M. A. 101:1958 ( (Dec. 16) ) 1934. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

INSULIN HYPOGLYCEMIA IN EPILEPSY

Archives of Neurology & Psychiatry , Volume 36 (2) – Aug 1, 1936

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Publisher
American Medical Association
Copyright
Copyright © 1936 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1936.02260080103006
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Abstract

Abstract In this study epileptic patients were given injections of insulin for the purpose of determining the rôle of hypoglycemia in precipitating seizures. Reports of many studies have appeared in the literature suggesting that epileptic attacks may be due to hypoglycemia. On the whole, the evidence has been indirect and not conclusive. Recent clinical knowledge of hyperinsulinism and other types of hypoglycemia has aroused attention anew to this problem. Harris1 reported three cases of hyperinsulinism and collected reports of twelve others (twelve of fifty recorded cases) in which convulsions were the predominant symptom. In several of these cases a diagnosis of epilepsy was made at first. The injection of insulin is known to induce convulsions in several species of animals. In fact, insulin was formerly assayed in rabbits by this method. Convulsions resulting from an overdose of insulin are of infrequent occurrence in adult human beings. Still, if hypoglycemia bears References 1. Harris, S.: Epilepsy and Narcolepsy Associated with Hyperinsulinism: Report of Three Cases of Epilepsy and of One Case of Narcolepsy Cured Clinically by Partial Resection of Body and Tail of Pancreas , J. A. M. A. 100:321 ( (Feb. 4) ) 1933.Crossref 2. Moracci, E.: Concerning Convulsions in Pigeons Arising from Substances Lowering the Blood Sugar: I. Investigation of the Factors Determining the Onset of Convulsions , Boll. d. Soc. ital. di biol. sper. 7:302, 1932. 3. Drabkin, D. L., and Shilkret, H.: Insulin Anhydremia: Importance of the Water-Reserve in a Physiologic Crisis , Am. J. Physiol. 83:141 ( (Dec.) ) 1927. 4. Benedict, S. R.: The Estimation of Sugar in Blood and Normal Urine , J. Biol. Chem. 68:759 ( (June) ) 1926. 5. Campbell, W. R., and Macleod, J. J. R.: Insulin , Medicine 3:195 ( (Aug.) ) 1924.Crossref 6. Voegtlin, C.: The Biological Standardization of Insulin: II. The Mortality and Glucose-Protective Test in Rats as a Method for the Bio-Assay of Insulin , Pub. Health Rep. 39:1935, 1924.Crossref 7. Griffith, J. P. C.: Hypoglycemia and the Convulsions of Early Life , J. A. M. A. 93:1526 ( (Nov. 16) ) 1929.Crossref 8. Frazier, C. H.: Pituitary Cachexia , Arch. Neurol. & Psychiat. 21:18 ( (Jan.) ) 1929. 9. Calder, R. M.: Anterior Pituitary Insufficiency (Simmond's Disease) , Bull. Johns Hopkins Hosp. 50:87 ( (Feb.) ) 1932. 10. Silver, S.: Simmond's Disease (Cachexia Hypophyseopriva): Report of a Case with Postmortem Observations and a Review of the Literature , Arch. Int. Med. 51:175 ( (Feb.) ) 1933. 11. Osler, W., and McCrae, T.: The Principles and Practice of Medicine , ed. 9, New York, D. Appleton & Co., 1922, p. 867. 12. Hartman, F. A.; Brownell, K. A., and Crosby, A. A.: The Relation of Cortin to the Maintenance of Body Temperature , Am. J. Physiol. 98:674 ( (Nov.) ) 1931. 13. Reismann, D.: Diseases of the Adrenal Glands , in Christian, H. A., and Mackenzie, J.: Oxford Medicine , New York, Oxford University Press, 1926, vol. 3, p. 784. 14. Mann, F. C.: Studies in the Physiology of the Liver: I. Technic and General Effects of Removal , Am. J. M. Sc. 161:37, 1921. 15. Baudouin, A.; Azerad, E., and Lewin, J.: Test of Hypoglycemia Produced by Insulin in Epileptics: Seventeen Cases , Compt. rend. Soc. de biol. 114: 902, 1933. 16. Labbé, M., and Escalier, A.: Disturbance of the Carbohydrate Regulation in Epileptics , Médecine 13:485 ( (July) ) 1932. 17. Pagniez, P.: Question of Existence of Epilepsy Due to Hypoglycemia , Presse méd. 41:876 ( (May 31) ) 1933. 18. Elias, H., and Goldstein, J.: Insulin Shock and the Central Nervous System: Insulin in the Focal Diagnosis of Cerebral Pathology , Med. Klin. 28:542 ( (April 15) ) 1932. 19. Lennox, W. G., and Cobb, S.: Epilepsy from the Standpoint of Physiology and Treatment , Baltimore, Williams & Wilkins Company, 1928. 20. Hrubetz, M. D.: Assay of Insulin and Blood Sugar Level , Am. J. Physiol. 107:284 ( (Feb.) ) 1934. 21. Harris, S.: Hyperinsulinism, a Definite Disease Entity: Etiology, Pathology, Symptoms, Diagnosis, Prognosis and Treatment of Spontaneous Insulinogenic Hypoglycemia , J. A. M. A. 101:1958 ( (Dec. 16) ) 1934.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Aug 1, 1936

References