title: Pathologic yawning in neuromyelitis optica spectrum disorders.
abstract: BACKGROUND
  Brainstem, hypothalamic and cerebral symptoms may occur in neuromyelitis optica spectrum disorders (NMOSD). However, pathologic yawning has not been previously described in NMOSD patients.
  
  
  METHODS
  Nine AQP4-IgG seropositive NMOSD patients experienced excessive yawning not related to sleep deprivation or fatigue.
  
  
  RESULTS
  Patients were female, aged 19-57 years (median, 39 years) at disease onset. Excessive yawning spells were the presenting symptom of the disease in five patients, lasted 2-16 weeks, and usually occurred in association with nausea, vomiting and hiccups. Brain MRI was abnormal in all patients and most frequently showed brainstem and hypothalamic lesions.
  
  
  CONCLUSIONS
  Pathologic yawning may be a neglected although not a rare symptom in NMOSD.
authors: CIEM MS Research Center, Federal University of Minas Gerais Medical School, Av. Alfredo Balena 100, Belo Horizonte, MG 30130-100, Brazil. Electronic address: marco.lanapeixoto@gmail.com.
authors: Marco A
authors: MA
authors: Lana-Peixoto
authors: Department of Neurology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo, 455, Sao Paulo, SP 01246903, Brazil. Electronic address: dgcallegaro@yahoo.com.
authors: Dagoberto
authors: D
authors: Callegaro
authors: CIEM MS Research Center, Federal University of Minas Gerais Medical School, Av. Alfredo Balena 100, Belo Horizonte, MG 30130-100, Brazil. Electronic address: talim.fono@gmail.com.
authors: Natália
authors: N
authors: Talim
authors: CIEM MS Research Center, Federal University of Minas Gerais Medical School, Av. Alfredo Balena 100, Belo Horizonte, MG 30130-100, Brazil. Electronic address: liviatalim@gmail.com.
authors: Livia E
authors: LE
authors: Talim
authors: Department of Neurology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo, 455, Sao Paulo, SP 01246903, Brazil. Electronic address: samira.apostolos.neuro@gmail.com.
authors: Samira A
authors: SA
authors: Pereira
authors: CIEM MS Research Center, Federal University of Minas Gerais Medical School, Av. Alfredo Balena 100, Belo Horizonte, MG 30130-100, Brazil.
authors: Gilberto Belisário
authors: GB
authors: Campos
keywords: Brainstem lesions; Hiccups; Hypothalamic lesions; Nausea/vomiting; Neuromyelitis optica spectrum disorders; Pathologic yawning