自从60年前发现胰岛素以来,有大量机会观察低血糖的神经病学后果。精神病患者和糖尿病患者中发生昏迷的总数很大。Kinsey 报道有12,000多例患者曾用胰岛素昏迷洽疗,据信用胰岛索治疗的糖尿病患者中有1/10每年至少有1次低血糖昏迷发作。然而,奇怪的是,Jaspan 等报道28例患者发生明显的特殊的周围神经病,其低血糖都不是由胰岛素治疗所致,而是由胰岛瘤所引起。这种周围神经病的临床表现与通常在糖尿病患者中所见到的不同,以累及运动神经和远端神经为主。手部往往严重受累,肌肉消瘦,精细动作障碍。严重病例亦可影响小腿,伴有双侧垂足症。感觉异常通常在肌无力之前发生,但是客观的感觉损害罕见。肌肉消瘦常在一系列严重低血糖 Since insulin was discovered 60 years ago, there is ample opportunity to observe the neurological consequences of hypoglycaemia. The total number of coma in mentally ill and diabetic patients is large. Kinsey reported that more than 12,000 patients had been treated with insulin coma, and one in 10 diabetic patients who are believed to have been treated with islet may have at least 1 hypoglycemic coma per year. However, curiously, Jaspan et al. Reported that 28 patients developed a distinct and specific peripheral neuropathy whose hypoglycemia was not caused by insulin treatment but rather by insulinomas. The clinical manifestations of this peripheral neuropathy differ from what is commonly seen in diabetic patients, involving the motor and distal nerves. Hand is often severely involved, muscle wasting, fine motor impairment. Severe cases can also affect the lower leg, accompanied by bilateral foot disease. Sensory abnormalities usually occur before muscle weakness, but objective sensory impairment is rare. Muscle weight loss is often a series of severe hypoglycemia