title: [Hypothermia and memory disturbance as initial manifestations associated with lesions of the diencephalon in a patient with anti-aquaporin 4 antibody-associated disorder: a case report].
abstract: A 69-year-old woman was admitted due to gradual progression of daytime sleepiness and forgetfulness over a period of approximately 1 month. Bradycardia and hypothermia were observed on admission, and neurological examination revealed memory disturbance, mild dysarthria, and bradykinesia. Fluid-attenuated inversion recovery (FLAIR) images of the brain magnetic resonance imaging (MRI) indicated signal hyperintensity in the region bordering the lateral and third ventricles. Serum anti-aquaporin 4 (AQP4) antibody was detected. The patient had no history or findings of optic neuritis or myelitis, and she was diagnosed as anti-AQP4 antibody-associated disorder. Diencephalon lesion and/or symptoms are rarely observed at the onset of neuromyelitis optica. Differential diagnosis of this disorder is necessary in cases manifesting diencephalon symptoms or involving lesions bordering the third ventricle without evidence of previous optic neuritis or myelitis.
authors.affiliation: Department of Neurology, Fujisawa City Hospital.
authors.forename: Tatsu
authors.initials: T
authors.lastname: Nakano
authors.forename: Fumi
authors.initials: F
authors.lastname: Dei
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kawamoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Tanaka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Koyama
mesh_terms: D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D020274:Autoimmune Diseases of the Nervous System / Q000150:complications* / Q000276:immunology*; D002552:Cerebral Ventricles / Q000473:pathology; D004027:Diencephalon / Q000473:pathology*; D004401:Dysarthria / Q000209:etiology; D005260:Female; D006801:Humans; D018476:Hypokinesia / Q000209:etiology; D007035:Hypothermia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008569:Memory Disorders / Q000209:etiology*; D009471:Neuromyelitis Optica / Q000209:etiology*
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies