Yoshikawa Sosuke, Suzuki Shuhei, Kanbayashi Takashi, Nishino Seiji, Tamai Hiroshi
Department of Pediatrics, Osaka Medical College, Osaka, Japan.
Pediatr Neurol. 2004 Nov;31(5):367-70. doi: 10.1016/j.pediatrneurol.2004.05.014.
A 7-year-old Japanese female diagnosed as having acute disseminated encephalomyelitis presented seizures, visual symptoms, and hypersomnia with bilateral lesions in the white matter, basal ganglia, and hypothalamus. Her clinical findings and demonstrated lesions in neuroimages were similar to those of Von Economo's encephalitis lethargica. Her hypocretin, the hypothalamic neuropeptide controlling sleep-awake cycle, was significantly low in the cerebrospinal fluid (146 pg/mL) on admission. Successive measures resulted in the gradual recovery of cerebrospinal fluid hypocretin to the normal range (263 pg/mL) as her excessive daytime sleepiness was reduced. Decreased hypothalamic hypocretin neurotransmission may be involved in this symptomatic case of hypersomnia associated with acute disseminated encephalomyelitis.
一名7岁日本女性被诊断为急性播散性脑脊髓炎，出现癫痫发作、视觉症状和嗜睡，白质、基底神经节和下丘脑有双侧病变。她的临床症状和神经影像显示的病变与冯·埃科诺莫昏睡性脑炎相似。她的脑脊液中控制睡眠-觉醒周期的下丘脑神经肽——下丘脑分泌素在入院时显著降低（146 pg/mL）。随着她白天过度嗜睡症状减轻，脑脊液下丘脑分泌素逐渐恢复到正常范围（263 pg/mL）。下丘脑分泌素神经传递减少可能与这例与急性播散性脑脊髓炎相关的嗜睡症状有关。
