目的　探讨低血糖性脑功能障碍的病因、临床特点、诊断和治疗。方法　对 4例长期误诊的低血糖性脑功能障碍患者的临床资料进行分析。结果　 4例均表现为发作性神经精神症状 ,空腹或发作时血糖 <2 .8mm ol/ L ,有高胰岛素血症 ,胰岛素释放指数为 2 .5～ 16 .2 ,腹部 B超和 CT正常 ;3例行剖腹探查 ,其中 1例为胰岛素瘤行手术切除 ,另 1例行胰腺部分切除术 ,经手术者疗效较佳。结论　低血糖性脑功能障碍的病因以胰岛素瘤引起的胰岛素不适当分泌过多为多见。对发作性神经精神症状患者应常规查空腹和发作时血糖及血浆胰岛素 ;若有高胰岛素血症时应行 B超和 CT检查 ,但肿瘤发现率不高 ;即使阴性 ,亦应剖腹探查 ,行胰腺部分切除术 Objective To investigate the etiology, clinical features, diagnosis and treatment of hypoglycemic brain dysfunction. Methods The clinical data of 4 patients with long-term misdiagnosis of hypoglycemic brain dysfunction were analyzed. Results All the 4 cases showed seizure neuropsychiatric symptoms. The fasting or seizure blood glucose <2 .8 mm ol / L, hyperinsulinemia, insulin release index of 2.5 ~ 16.2, abdominal ultrasound and CT were normal; 3 cases of laparotomy exploration, of which 1 case of insulinoma underwent surgical resection, another case of partial pancreatectomy, the better effect of surgery. Conclusions The cause of hypoglycemic brain dysfunction is prevalent due to improper insulin secretion caused by insulinoma. On the onset of neuropsychiatric symptoms should be routinely check fasting and seizures when blood glucose and plasma insulin; if hyperinsulinemia should be performed B ultrasound and CT examination, but the tumor was not found; even negative, should also exploratory laparotomy, line Partial pancreatectomy