Hypoglycemia may present without classic symptoms especially in young patients and may imitate every neurological symptom. Undiagnosed hypoglycemia may be covered as traumatic, neurological, toxicological and psychiatric disorders.

We are presenting a rare case of acute hypoglycemia at a 14 years old girl admitted at Child and Adolescent Psychiatry Clinic. She presented with a panic attack and hypo maniacal symptoms.

This was an unusual presentation creating a diagnostic dilemma. To the best of our knowledge this is the first reported case of hypoglycemia presenting in adolescents as acute hypomania.

Mrs. A. B. is an Albanian girl 14 years old, with no prior history of mental disorders. She was brought to the child/adolescent psychiatry by her parents because of somatic complains, such as headache, fatigue, dizziness.

Our case provides a unique look at how a simple abnormality when overlooked can present as a difficult diagnostic challenge for both medicine and psychiatry services. Particular care should be exercised when dealing with psychiatric patients with these entities so that hypoglycemia is not missed. Significant medical harm to the patient and medicolegal risks for the emergency physician are issues to consider in cases involving misdiagnosis, incorrect therapy, and inappropriate disposition.