CASE HISTORY AND EXAMINATION
A 44-year-old female patient was admitted to our department on January
30, 2020, following recurrent syncope and profuse sweating over the past
two years, with worsening symptoms in the last month. The patient
experienced recurrent syncope accompanied by profuse sweating, without
an obvious trigger, for the past two years. These episodes primarily
occurred in the early morning, but were alleviated by eating, with
approximately one episode every six months. The patient denied any
speech abnormalities or hemiplegia. Previously, the patient received
treatment at a local hospital, where an intravenous random blood glucose
measurement revealed a level of 54.72 mg/dL, indicating hypoglycemia.
Imaging studies, including chest, abdominal, and cranial CT scans,
revealed no abnormalities, and thus no additional treatment was
administered.
The patient started undergoing frequent seizures approximately one month
ago, occurring once a week. Accompanying these seizures, she experienced
impaired consciousness and incoherent speech, with symptom relief after
eating. The patient was admitted to the hospital for evaluation of
syncope. Over the past two years, the patient’s dietary intake had
increased, resulting in a weight gain of approximately 5 kg. Her medical
history included a cesarean-section hemorrhage, followed by regular
menstruation after delivery. For the past five years, she had been
dealing with hypertension, although her treatment adherence was
inconsistent. There were no notable findings in her family medical
history.
The patient’s vital signs were stable during the physical examination.
Her height measured 153 cm, weight 74 kg, with a BMI of 31.61 kg/m². The
patient was alert and provided relevant answers. No signs of acanthosis
nigricans or hyperpigmentation were observed on the skin or mucous
membranes. Axillary and pubic hair appeared within normal limits. No
enlargement of the thyroid gland was noted. Cardiopulmonary and
abdominal examinations revealed no abnormalities. Muscle strength and
tone in the extremities were within normal limits. No pathological signs
were detected.