患者,男,64岁,因反复发作傻笑、幼稚动作3天于2000年3月2日来我院就诊。近3天来患者无明显诱因常于夜间出现傻笑、作鬼脸、向家人吐口水,伴大汗,持续约2～5min可自行缓解。缓解后患者神志清,仍感头晕、心悸、反应迟钝,不能回忆起发病当时的情况,遂至我院精神科就诊。在症状发作时急查血糖为1.6mmol/L,免疫反应性胰岛素251pmol/L,胰岛素C肽 The patient, male, 64 years old, came to our hospital on March 2nd, 2000 due to repeated giggles and childish movements for 3 days. In the past 3 days, there was no obvious incentive for the patient to have a giggle at night, make a grimace, spit on the family, and accompanied by sweat, which lasted for about 2 to 5 minutes. After remission, the patient was clear-headed and still felt dizzy, palpitations, and unresponsive. He could not recall the condition at the time of illness and went to the psychiatric department of our hospital. At the onset of symptoms, the acute blood glucose is 1.6 mmol/L, immunoreactive insulin is 251 pmol/L, insulin C-peptide