Episodic spontaneous hypothermia: a periodic childhood syndrome.
Episodic spontaneous hypothermia is an infrequent disorder, with unknown pathogenic mechanisms. A systemic cause or underlying brain lesion has not been found for the disease. We report four new patients, 3-9 years old, with episodic hypothermia lower than 35 degrees C, marked facial pallor, and absent shivering. The episodes could last a few hours or four days, and recurred once a week or every 2-3 months. Two patients also demonstrated bradycardia, mild hypertension, and somnolence during the events; in one of them, profuse sweating was also a feature, and all four presented with either headache, a periodic childhood syndrome, or both (recurrent abdominal pain, cyclic vomiting, or vertigo). Three patients reported a family history of migraine. Neurologic examination, endocrine function, and imaging studies were normal. Migraine prophylactic therapy was of moderate efficacy. Spontaneous resolution was observed in one patient. The clinical characteristics of the syndrome allow for its inclusion as a childhood periodic syndrome related to migraine.
Ruiz
Cynthia
C
Division of Child Neurology, Hospital de Cruces, Basque Country, Spain.
Gener
Blanca
B
Garaizar
Carmen
C
Prats
José M
JM
D015746:Abdominal Pain / Q000209:etiology; D001831:Body Temperature; D001919:Bradycardia / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003244:Consciousness Disorders / Q000209:etiology; D003533:Cyproheptadine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005444:Flunarizine / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007035:Hypothermia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D007223:Infant; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D009460:Neurologic Examination; D010507:Periodicity; D012016:Reference Values; D012075:Remission, Spontaneous; D013577:Syndrome
D003533:Cyproheptadine; D005444:Flunarizine