title: Hypersomnia and low CSF hypocretin-1 (orexin-A) concentration in a patient with multiple sclerosis showing bilateral hypothalamic lesions.
abstract: A 45-year-old Japanese woman with multiple sclerosis (MS) manifested hypersomnia in a relapse of MS. Magnetic resonance imaging revealed new bilateral hypothalamic lesions, and the hypocretin-1 level in the cerebrospinal fluid (CSF) was significantly low. Methylprednisolone pulse treatment successfully resolved the hypersomnia and the left hypothalamic lesion, and it normalized the hypocretin-1 level in the CSF. These findings suggest that the hypothalamic hypocretin (orexin) system may be crucial to maintaining the arousal level and that lesions in the system can cause hypersomnia in MS.
authors.affiliation: Department of Neurology, Toyoshina Red-Cross Hospital, Nagano.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanbayashi
authors.forename: Kanji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
authors.forename: Takao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Ikeda
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002352:Carrier Proteins / Q000134:cerebrospinal fluid*; D002555:Cerebrospinal Fluid / Q000737:chemistry; D006970:Disorders of Excessive Somnolence / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D047908:Intracellular Signaling Peptides and Proteins; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy; D009479:Neuropeptides / Q000134:cerebrospinal fluid*; D000068797:Orexins; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D002352:Carrier Proteins; C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins; D008775:Methylprednisolone