Somnolence Preceded the Development of a Subthalamic Lesion in Neuromyelitis Optica Spectrum Disorder: A Case Report.

Somnolence Preceded the Development of a Subthalamic Lesion in Neuromyelitis Optica Spectrum Disorder: A Case Report. Intern Med. 2019 Oct 15;: Authors: Daida K, Ogaki K, Hayashida A, Ando M, Yokoyama K, Noda K, Kanbayashi T, Hattori N, Okuma Y Abstract A 67-year-old woman with neuromyelitis optica spectrum disorder (NMOSD) developed severe somnolence. Ten days after admission, fluid-attenuated inversion-recovery magnetic resonance imaging (MRI) revealed hyperintense areas around the bilateral hypothalamus, which were not present on MRI at admission. The orexin level, which is decreased in idiopathic narcolepsy, was slightly decreased in her cerebrospinal fluid. Immunosuppressive treatment and methylphenidate markedly improved her somnolence. This case shows that NMOSD in the acute phase can cause somnolence in a patient without apparent lesions in the hypothalamus. PMID: 31611526 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research

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Publication date: Available online 29 May 2019Source: NeuroImage: ClinicalAuthor(s): Natasha Morales Drissi, Marcel Warntjes, Alexander Wessén, Attila Szakacs, Niklas Darin, Tove Hallböök, Anne-Marie Landtblom, Helena Gauffin, Maria EngströmAbstractThe aim of this study was to investigate structural changes in the brain stem of adolescents with narcolepsy, a disorder characterized by excessive daytime sleepiness, fragmented night-time sleep, and cataplexy. For this purpose, we used quantitative magnetic resonance imaging to obtain R1 and R2 relaxation rates, proton density, and myelin maps in adolesce...
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
AbstractWhite matter alterations related to hypocretin pathway have been less evaluated in patients who have narcolepsy with cataplexy (NC), as compared to the identified exploration of gray matter and have varied among structural brain magnetic resonance imaging studies. The aim of this study was to investigate the disruption of specific white matter tracts in drug-na ïve patients with NC, by using a tract-specific statistical analysis (TSSA). Forty drug-naïve NC patients with cataplexy and 42 heathy controls were enrolled in the study. All participants completed diffusion weighted imaging, polysomnography, and ...
Source: Brain Imaging and Behavior - Category: Neurology Source Type: research
This study indicated that switch from H2 blockers to PPIs reduced delirium and, thus, providing an appropriate strategy to combat drug-induced delirium using antiulcer drugs (Fujii et al., 2012). The ventrolateral preoptic nucleus is a sleep-promoting nucleus located in the basal forebrain. A commonly used intravenous anesthetic, propofol, had been reported to induce sleep and augment the firing rate of neurons in ventrolateral GABAergic preoptic nucleus, but the underlining mechanism is yet to be clearly determined. Interestingly, the propofol-induced inhibition of inhibitory postsynaptic currents on noradrenalin-inhibite...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ute; J, Vaněčková M, Němcová V Abstract Narcolepsy with cataplexy is a lifelong disease resulting from the loss of hypocretin neurons in the hypothalamus; structural changes are not, however, limited only to the hypothalamus. We previously revealed an overall hippocampal volume loss in narcolepsy with cataplexy. The aim of this study is to describe the volume reduction of the anterior and posterior parts of the hippocampus in patients with narcolepsy with cataplexy in comparison with a control group. The anterior hippocampus is more involved in episodic memory and imagination, and the posterior hi...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
AbstractNarcolepsy with cataplexy is a lifelong disease resulting from the loss of hypocretin neurons in the hypothalamus; structural changes are not, however, limited only to the hypothalamus. We previously revealed an overall hippocampal volume loss in narcolepsy with cataplexy. The aim of this study is to describe the volume reduction of the anterior and posterior parts of the hippocampus in patients with narcolepsy with cataplexy in comparison with a control group. The anterior hippocampus is more involved in episodic memory and imagination, and the posterior hippocampus in spatial memory. Manual magnetic resonance ima...
Source: Journal of Sleep Research - Category: Neurology Authors: Tags: REGULAR RESEARCH PAPER Source Type: research
Pradeep Kallollimath, Amruth Gujjar, Megharanjini PatilAnnals of Indian Academy of Neurology 2018 21(2):156-158 Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness. It can be either primary or symptomatic due to other neurologic disorders. Neuromyelitis optica (NMO) is an inflammatory demyelinating disorder in which symptomatic narcolepsy is being described as one of the core clinical features. Here, we report a patient with NMO who presented with narcolepsy. Signal changes on magnetic resonance imaging in hypothalamus and other periventricular regions of high aquaporin-4 expression should prompt ...
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research
We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents. Keywords: narcolepsy, adolescence, misdiagnosis Innov Clin Neurosci. 2017;14(9–10):20–23 Introduction Narcolepsy is an uncommon sleep cycle disorder characterized by the tetrad of chronic excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis.1 The cardinal symptom of paroxysmal sleep is seen in all patients, whereas other symptoms such as ...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue adolescence misdiagnosis narcolepsy Source Type: research
In this report, a pituitary mass is described as a unique cause of narcolepsy‐cataplexy in a dog. A 6‐year‐old male neutered Dachshund had presented for acute onset of feeding‐induced cataplexy and was found to have a pituitary macrotumor on magnetic resonance imaging (MRI). Cerebral spinal fluid hypocretin‐1 levels were normal, indicating that tumor effect on the ventral lateral nucleus of the hypothalamus was not the cause of the dog's narcolepsy‐cataplexy. The dog was also negative for the hypocretin receptor 2 gene mutation associated with narcolepsy in Dachshunds, ruling out familial narcolepsy. The Dachsh...
Source: Journal of Veterinary Internal Medicine - Category: Veterinary Research Authors: Tags: Case Report Source Type: research
Summary Functional imaging studies and voxel‐based morphometry analysis of brain magnetic resonance imaging showed abnormalities in the hypothalamus–thalamus–orbitofrontal pathway, demonstrating altered hypocretin pathway in narcolepsy. Those distinct morphometric changes account for problems in wake–sleep control, attention and memory. It also raised the necessity to evaluate white matter changes. To investigate brain white matter alterations in drug‐naïve narcolepsy patients with cataplexy and to explore relationships between white matter changes and patient clinical characteristics, drug‐na&...
Source: Journal of Sleep Research - Category: Neurology Authors: Tags: Regular Research Paper Source Type: research
Conclusions:Narcolepsy type 1 may occur in association with idiopathic generalized epilepsy, leading to remarkable diagnostic and therapeutic challenges. Electrophysiological studies as well as a comprehensive somnologic interview can help confirm the diagnosis in patients with ambiguous neurological history. Sodium oxybate in combination with antiepileptic drugs is safe and effective in treating cataplexy and excessive daytime sleepiness.Citation:Baiardi S, Vandi S, Pizza F, Alvisi L, Toscani L, Zambrelli E, Tinuper P, Mayer G, Plazzi G. Narcolepsy type 1 and idiopathic generalized epilepsy: diagnostic and therapeutic cha...
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
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