Kume Kodai, Deguchi Kazushi, Ikeda Kazuyo, Takata Tadayuki, Kokudo Yohei, Kamada Masaki, Touge Tetsuo, Takahashi Toshiyuki, Kanbayashi Takashi, Masaki Tsutomu
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan.
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Mult Scler. 2015 Jun;21(7):960-2. doi: 10.1177/1352458515569100. Epub 2015 Feb 13.
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.
我们报告了一例46岁的日本女性视神经脊髓炎谱系障碍患者，该患者反复出现嗜睡，同时脑脊液中食欲素水平降低。首次发作与下丘脑 - 垂体功能障碍相关，显示双侧下丘脑病变，可导致食欲素神经元继发性损伤。第二次发作与记忆力受损相关，显示左侧颞叶病变累及杏仁核。其机制尚不清楚，但杏仁核病变同侧下丘脑血流减少提示继发于杏仁核功能受损的跨突触下丘脑功能障碍。累及杏仁核和下丘脑的颞叶病变可能是视神经脊髓炎谱系障碍导致嗜睡的原因。
