title: A case of acute disseminated encephalomyelitis presenting hypersomnia with decreased hypocretin level in cerebrospinal fluid.
abstract: A 12-year-old girl was diagnosed as having acute disseminated encephalomyelitis and manifested hypersomnia as the main clinical feature. Magnetic resonance imaging (MRI) revealed lesions in the bilateral hypothalamus in addition to other multifocal brain lesions involving the cerebral white matter, brain stem, and basal ganglia. The level of hypocretin in cerebrospinal fluid was decreased in this patient. Corticosteroid treatment resulted in improvement of the hypersomnia and resolution of MRI lesions in the hypothalamus and other regions. This case suggests that the arousal state control mechanism related to the hypocretin peptide/receptor system may be impaired in some patients with acute disseminated encephalomyelitis.
authors.affiliation: Chiba Children's Hospital, Department of Pediatrics, Graduate School of Medicine, Chiba University, Japan. h-kubota@ta2.so-net.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kubota
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanbayashi
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Takanashi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kohno
mesh_terms: D002352:Carrier Proteins / Q000134:cerebrospinal fluid*; D002648:Child; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis*; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008279:Magnetic Resonance Imaging; D009479:Neuropeptides / Q000134:cerebrospinal fluid* / Q000172:deficiency*; D000068797:Orexins; D011239:Prednisolone / Q000627:therapeutic use; D011863:Radioimmunoassay; D016896:Treatment Outcome
chemical_list: D002352:Carrier Proteins; D005938:Glucocorticoids; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins; D011239:Prednisolone