Neuromyelitis optica spectrum disorder presenting with repeated hypersomnia due to involvement of the hypothalamus and hypothalamus-amygdala linkage.

Abstract

We report the case of a 46-year-old Japanese woman with neuromyelitis optica spectrum disorder presenting with repeated hypersomnia accompanied by decreased CSF orexin level. First episode associated with hypothalamic-pituitary dysfunction showed bilateral hypothalamic lesions that can cause secondary damage to the orexin neurons. The second episode associated with impaired memory showed a left temporal lesion involving the amygdala. The mechanism remains unknown, but the reduced blood flow in the hypothalamus ipsilateral to the amygdala lesion suggested trans-synaptic hypothalamic dysfunction secondary to the impaired amygdala. A temporal lesion involving the amygdala and hypothalamus could be responsible for hypersomnia due to neuromyelitis optica spectrum disorder.

• Authors: Kodai Kume, Kazushi Deguchi, Kazuyo Ikeda, Tadayuki Takata, Yohei Kokudo, Masaki Kamada, Tetsuo Touge, Toshiyuki Takahashi, Takashi Kanbayashi, Tsutomu Masaki
• Journal: Multiple sclerosis (Houndmills, Basingstoke, England) (Mult Scler) Vol. 21 Issue 7 Pg. 960-2 (Jun 2015) ISSN: 1477-0970 [Electronic] England
• PMID: 25680985 (Publication Type: Case Reports, Journal Article)
• Copyright: © The Author(s), 2015.

Chemical References

• Orexins

Topics

• Amygdala (pathology)
• Disorders of Excessive Somnolence (etiology)
• Female
• Humans
• Hypothalamus (pathology)
• Magnetic Resonance Imaging
• Middle Aged
• Neuromyelitis Optica (cerebrospinal fluid, complications, pathology)
• Orexins (cerebrospinal fluid)