Pancreatectomy (removal of a portion or nearly all of the pancreas) is usually a treatment of last resort when the less-drastic medical measures fail to provide prolonged normal blood sugar levels. For some time, the most common surgical procedure was removal of almost all of the pancreas; this cured some infants but not all. Insulin-dependent diabetes mellitus commonly develops, though in many cases it occurs many years after the pancreatectomy. Later it was discovered that a sizeable minority of cases of mutations were focal, involving overproduction of insulin by only a portion of the pancreas. These cases can be cured by removing much less of the pancreas, resulting in excellent outcomes with fewer long-term problems. History
This condition has been referred to by a variety of names in the past 50 years; nesidioblastosis and islet cell adenomatosis were favored in the 1970s, beta cell dysregulation syndrome or dysmaturation syndrome in the 1980s, and persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in the 1990s. See also
Hyperammonemia
List of congenital disorders

References
Further reading
Hoyme, Louanne Hudgins; Toriello, Helga V.; Enns, Gregory M.; Hoyme, H. Eugene (2014). Signs and symptoms of genetic disease : a handbook. Oxford: Oxford University Press. ISBN 9780199930975. Hertz, David E., ed. (2005). Care of the newborn a handbook for primary care. Philadelphia: Lippincott Williams & Wilkins. ISBN 9780781755856. External links
PubMed
After four to six months of regular benzodiazepine use, evidence of continued efficacy declines.If regular treatment is continued for longer than four to six months, dose increases may be necessary to maintain effects, but treatment-resistant symptoms may in fact be benzodiazepine withdrawal symptoms. Due to the development of tolerance to the anticonvulsant effects, benzodiazepines are generally not recommended for long-term use for the management of epilepsy. Increasing the dose may overcome tolerance, but tolerance may then develop to the higher dose and adverse effects may persist and worsen. The mechanism of tolerance to benzodiazepines is complex and involves GABAA receptor downregulation, alterations to subunit configuration of GABAA receptors, uncoupling and internalisation of the benzodiazepine binding site from the GABAA receptor complex as well as changes in gene expression.The likelihood of dependence is relatively high with lorazepam compared to other benzodiazepines. Lorazepams relatively short serum half-life, its confinement mainly to blood, and its inactive metabolite can result in interdose withdrawal phenomena and next-dose cravings, that may reinforce psychological dependence. Because of its high potency, the smallest lorazepam tablet strength of 0.5 mg is also a significant dose. To minimise the risk of physical/psychological dependence, lorazepam is best used only short-term, at the smallest effective dose. If any benzodiazepine has been used long-term, the recommendation is a gradual dose taper over a period of weeks, months or longer, according to dose and duration of use, the degree of dependence and the individual.