病例报告：下丘脑室旁核区域功能障碍导致患者出现嗜睡症。
Case Report: Dysfunction of the Paraventricular Hypothalamic Nucleus Area Induces Hypersomnia in Patients.
作者信息
Wang Zan, Zhong Yu-Heng, Jiang Shan, Qu Wei-Min, Huang Zhi-Li, Chen Chang-Rui
机构信息
Department of Neurology, The First Hospital of Jilin University, Changchun, China.
State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China.
出版信息
Front Neurosci. 2022 Mar 14;16:830474. doi: 10.3389/fnins.2022.830474. eCollection 2022.
BACKGROUND
Hypersomnia is a common and highly impairing symptom marked by pathological excessive sleepiness, which induces suboptimal functioning and poor quality of life. Hypersomnia can be both a primary (e.g., hypersomnolence disorder) and secondary (e.g., tumors, and head trauma) symptom of disorders. However, its underlying mechanisms remain largely unknown.
CASE PRESENTATION
We report that three clinical cases with lesions around the paraventricular nucleus of the hypothalamus (PVH) area showed excessive daytime sleepiness and a prolonged nocturnal sleep lasting more than 20 h per day. Sleep architecture and subjective daytime sleepiness were examined by polysomnography. These cases were presented with stroke, myelin oligodendrocyte glycoprotein (MOG) antibody associated disorders and neuromyelitis optical spectrum disorder (NMOSD), respectively. Magnetic resonance imaging (MRI) showed lesions around the PVH area in all these three patients. After treatment of their primary disorders, their excessive sleep decreased as the PVH area recovered.
CONCLUSION
Our findings suggest that the PVH may play an essential role in the occurrence of hypersomnia.
背景
发作性睡病是一种常见且严重影响生活的症状，其特征为病理性过度嗜睡，会导致功能欠佳和生活质量低下。发作性睡病既可以是原发性疾病（如发作性睡病障碍）的症状，也可以是继发性疾病（如肿瘤和头部外伤）的症状。然而，其潜在机制在很大程度上仍不明确。
病例报告
我们报告了3例下丘脑室旁核（PVH）区域周围有病变的临床病例，这些病例均表现出白天过度嗜睡以及夜间睡眠时间延长，每天超过20小时。通过多导睡眠图检查睡眠结构和主观白天嗜睡情况。这些病例分别患有中风、髓鞘少突胶质细胞糖蛋白（MOG）抗体相关疾病和视神经脊髓炎谱系障碍（NMOSD）。磁共振成像（MRI）显示所有这3例患者的PVH区域周围均有病变。在对其原发性疾病进行治疗后，随着PVH区域的恢复，他们的过度睡眠情况有所减轻。
结论
我们的研究结果表明，PVH可能在发作性睡病的发生中起重要作用。
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