Hypersomnia and low cerebrospinal fluid hypocretin levels in acute disseminated encephalomyelitis.
A 7-year-old Japanese female diagnosed as having acute disseminated encephalomyelitis presented seizures, visual symptoms, and hypersomnia with bilateral lesions in the white matter, basal ganglia, and hypothalamus. Her clinical findings and demonstrated lesions in neuroimages were similar to those of Von Economo's encephalitis lethargica. Her hypocretin, the hypothalamic neuropeptide controlling sleep-awake cycle, was significantly low in the cerebrospinal fluid (146 pg/mL) on admission. Successive measures resulted in the gradual recovery of cerebrospinal fluid hypocretin to the normal range (263 pg/mL) as her excessive daytime sleepiness was reduced. Decreased hypothalamic hypocretin neurotransmission may be involved in this symptomatic case of hypersomnia associated with acute disseminated encephalomyelitis.
Yoshikawa
Sosuke
S
Department of Pediatrics, Osaka Medical College, Osaka, Japan.
Suzuki
Shuhei
S
Kanbayashi
Takashi
T
Nishino
Seiji
S
Tamai
Hiroshi
H
D002648:Child; D006970:Disorders of Excessive Somnolence / Q000134:cerebrospinal fluid* / Q000209:etiology* / Q000473:pathology; D004673:Encephalomyelitis, Acute Disseminated / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid*; D008279:Magnetic Resonance Imaging; D009479:Neuropeptides / Q000134:cerebrospinal fluid*; D000068797:Orexins
D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins