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Journal of Child Neurology, Vol. 17, No. 7, 537-539 (2002)
DOI: 10.1177/088307380201700713

A Case of Acute Disseminated Encephalomyelitis Presenting Hypersomnia With Decreased Hypocretin Level in Cerebrospinal Fluid

Hiroaki Kubota, MD

Division of Neurology Chiba Children's Hospital Department of Pediatrics Graduate School of Medicine Chiba University Chiba, Japan

Takashi Kanbayashi, MD

Department of Neuropsychiatry Akita University School of Medicine Akita, Japan

Yuzo Tanabe, MD

Division of Neurology Chiba Children's Hospital Jun-ichi Takanashi, MD

Yoichi Kohno, MD

Department of Pediatrics Graduate School of Medicine Chiba University Chiba, Japan

A 12-year-old girl was diagnosed as having acute disseminated encephalomyelitis and manifested hypersomnia as the main clinical feature. Magnetic resonance imaging (MRI) revealed lesions in the bilateral hypothalamus in addition to other multifocal brain lesions involving the cerebral white matter, brain stem, and basal ganglia. The level of hypocretin in cerebrospinal fluid was decreased in this patient. Corticosteroid treatment resulted in improvement of the hypersomnia and resolution of MRI lesions in the hypothalamus and other regions. This case suggests that the arousal state control mechanism related to the hypocretin peptide/receptor system may be impaired in some patients with acute disseminated encephalomyelitis. (J Child Neurol 2002;17:537-539).


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