title: [A 39 years old woman responding to modafinil with bilateral hypothalamic lesion associated with hyperthermia and hypersomnia: a case report].
abstract: A 39 years old woman was admitted to our hospital with a status epilepticus, with high fever of 41°C. Magnetic resonance Imaging (MRI) revealed high signal intensities of both sides of thalami and hypothalami in T2 weighted and fluid attenuated inversion recovery (FLAIR) images. A needle biopsy of the thalamic lesion was consistent with neuromyelitis optica spectrum disorder although her serum antibody to aquaporin-4 was negative. The level of orexin in celebrospinal fluid (CSF) was reduced. She presented hypersomnia, which didn't improve even after intravenous methylprednisolone 1 g daily for 3 days. Administration of oral modafinil extended her waking time. There is a number of reports about neuromyelitis optica (NMO) with hypothalamic lesions. We report this case as important suggestion of treatment of these cases.
authors.affiliation: Department of Neurology, National Center of Grobal Health and Medicine.
authors.forename: Naoko
authors.initials: N
authors.lastname: Saito
authors.forename: Masato
authors.initials: M
authors.lastname: Inoue
authors.forename: Kanehiro
authors.initials: K
authors.lastname: Hasuo
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanbayashi
authors.forename: Shigeo
authors.initials: S
authors.lastname: Murayama
authors.forename: Sosuke
authors.initials: S
authors.lastname: Takeuchi
mesh_terms: D001559:Benzhydryl Compounds / Q000008:administration & dosage*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001706:Biopsy; D001921:Brain / Q000473:pathology; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D047908:Intracellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid; D008279:Magnetic Resonance Imaging; D000077408:Modafinil; D009471:Neuromyelitis Optica / Q000150:complications* / Q000188:drug therapy*; D009479:Neuropeptides / Q000134:cerebrospinal fluid; D000068797:Orexins; D013786:Thalamic Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D064690:Wakefulness-Promoting Agents / Q000008:administration & dosage*
chemical_list: D001559:Benzhydryl Compounds; D015415:Biomarkers; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins; D064690:Wakefulness-Promoting Agents; D000077408:Modafinil