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Archives of neurology 2012-Oct

Hypothermia, hypotension, hypersomnia, and obesity associated with hypothalamic lesions in a patient positive for the anti-aquaporin 4 antibody: a case report and literature review.

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Keisuke Suzuki
Toshiki Nakamura
Kenichi Hashimoto
Masayuki Miyamoto
Tomoko Komagamine
Takahide Nagashima
Naoki Izawa
Takashi Kanbayashi
Toshiyuki Takahashi
Koichi Hirata

キーワード

概要

OBJECTIVE

To describe a patient positive for the anti-aquaporin 4 antibody with hypothalamic lesions showing hypothermia, hypotension, hypersomnia, and obesity.

METHODS

Case report.

METHODS

University hospital.

METHODS

We describe a 21-year-old woman who was positive for anti-aquaporin 4 antibody and presented with hypothermia, hypotension, and hypersomnia owing to bilateral hypothalamic lesions as the only abnormal clinical finding.

RESULTS

Immediate steroid administration resulted in significant improvement of the patient's vital signs and imaging findings; however, her cognitive impairment and sleepiness persisted, and she subsequently developed obesity. Decreased cerebrospinal fluid orexin levels and sleep studies confirmed the diagnosis of narcolepsy due to medical condition. Physicians should be aware that neuromyelitis optica spectrum disorders can initially involve the hypothalamus.

CONCLUSIONS

We emphasize that measurement of anti-aquaporin 4 antibody is of clinical importance in the differential diagnosis of hypothalamic lesions.

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