Key wordsC'n~~ii)/ic.citioiis; hypoglycaemic encephalopathy. S~i r g c q~; p haeoch ro niocy t oina reinova I.Many coinplications that follow surgery on phaeochromocytoma have been reported and mainly concern bleeding. haemodynamic disturbances. cardiac dysrhythmias and fluid balance problems. Phaeochromocytoma is also associated with a diabetic syndrome that presents with hyperglycaemia both pre-and postoperatively.However, some patients may develop hypoglycaemia d uring surgery and immediately postoperatively, due to a rebound insulin storm as ;I result of inhibition of catecholaminc secretion following removal of the timiour. Here we describe a case of hypoglycaemic eneephalopathy that resulted from hypoglycaemia o f nearly 4 hours' duration. which subsequently resolved without sequelae. Case historyAn 18-year-old Saudi male presented with intermittent attacks of severe headache, dizziness, palpitations and sweating that occurred over a period or 12 months. Blood pressure measurement during one such episode revealed severe hypertension and he was referred to King Khalid Hospital with a provisional diagnosis of phacochroniocytoma.On examination he was a healthy young man o f normal intelligence and behaviour. General and systematic examination revcaled n o abnormality. He remained normotensive apart from ~w o brief elevations of arterial blood prcssurc to 170.'90 mniHg.A series of 24-hour urine samples showed elevation of vanillyl mandclic acid to thrcc times the normal level. Ultrasonography and CT scan revealed a k n i inass in the right adrenal gland. The left adrenal was normal in size and shape. A diagnosis of phaeochromoeytoma of the right adrenal gland was made and he was prepared for surgery with a 4-day course of phcnoxy-

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