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Hypothalamic Lesion


Presentation

  • Abstract A 38-year-old man presented with chronic hypothermia. He also had evidence of hypothalamo-pituitary dysfunction and CT scans showed a discrete hypothalamic lesion.[ncbi.nlm.nih.gov]
  • Despite the seldom occurrence of SIADH in MS, hypothalamic lesions are more common than appreciated and should be considered in patients presenting with hyponatremia or endocrinopathy symptoms. The Author(s), 2014.[ncbi.nlm.nih.gov]
  • All cases in present study responded well to pharmacotherapy and surgery was not required.[annalsofian.org]
  • In younger patients germinomas often present themselves through precocious puberty, a condition in which the onset of puberty is significantly premature, often before the age of eight (Klaus,n.d).[123helpme.com]
  • The third patient presented diabetes insipidus associated with corticotropic insufficiency (7). A solitary hypothalamopituitary lesion was demonstrated on MR imaging.[path.upmc.edu]
Fever
  • By reducing the activity of warm-sensitive neurons and increasing the activity of cold-sensitive neurons, pyrogens cause fever, a state in which all thermoregulatory responses have elevated set-point temperatures.[ncbi.nlm.nih.gov]
  • […] in a dog, antithyroid antibodies led to hypothyroidism and adipsia, both of which resolved with levothyroxine therapy. [6] "Sickness behavior" is a condition in animals in which systemic infection leads to a highly regulated set of responses such as fever[emedicine.medscape.com]
  • […] oxytocin levels reduce repetitive behaviors and improved ability to interpret emotions water inteake (thirst center) inhibit food intake (satiety center); docility homeostasis-- also respiratory center regulates response to heat -- PNS outflow GnRH, LHRH, fever[quizlet.com]
  • Case Report Case Report American Journal of Neuroradiology September 2011, 32 (8) E153-E155; DOI: Abstract SUMMARY: This study describes a case of a patient with OSMS who presented with somnolence, periodic fever, memory impairment, and amenorrhea.[ajnr.org]
  • Periodic disorders. 28.1 Kleine-Levin syndrome (periodic somnolence and morbid hunger). 28.2 Spontaneous periodic fever, hypothermia, Shapiro syndrome and periodic Cushing's syndrome. 28.3 Acute intermittent porphyria. 28.4 Narcolepsy. 28.5 Epileptic[elsevier.com]
Hypothermia
  • Abstract A 38-year-old man presented with chronic hypothermia. He also had evidence of hypothalamo-pituitary dysfunction and CT scans showed a discrete hypothalamic lesion.[ncbi.nlm.nih.gov]
  • Although periodic hypothermia or hyperthermia has been occasionally reported in MS, hyperthemia and disturbances in the sleep-wake cycle and amenorrhea as a result of hypothalamic disease have not been previously reported among subjects with MS.[ajnr.org]
  • Periodic disorders. 28.1 Kleine-Levin syndrome (periodic somnolence and morbid hunger). 28.2 Spontaneous periodic fever, hypothermia, Shapiro syndrome and periodic Cushing's syndrome. 28.3 Acute intermittent porphyria. 28.4 Narcolepsy. 28.5 Epileptic[elsevier.com]
  • […] hypokalemia低カリウム血[症] hypoparathyroidism上皮小体[機能]低下[症]、副甲状腺[機能]低下[症] hypopituitarism下垂体機能低下症 hypothalamic hormone視床下部ホルモン hypothalamohypophysial portalvein視床下部-下垂体門脈 hypothalamohypophysial system視床下部-下垂体系 hypothalamus-pituitary-adrenalaxis視床下部-下垂体-副腎系 hypothermia[tokyo-med.ac.jp]
  • Structural causes of obesity, anorexia, central hypothermia and hyperthermia, insomnia, and hypersomnia are only very rarely demonstrated.[ajnr.org]
Family History of Epilepsy
  • There was no family history of epilepsy. Patient was mentally retarded.[annalsofian.org]
Excessive Daytime Sleepiness
  • Narcolepsy is characterized by excessive daytime sleepiness (EDS), cataplexy and other abnormal manifestations of REM sleep.[ci.nii.ac.jp]
Increased Appetite
  • DYSTROPHIA ADIPOSOGENITALIS  Characterized by increased appetite and depressed secretion of gonadotropin  Obesity and sexual infantilism  Associated with dwarfism (if the condition occurs during growing period)  It is also called Frohlich’s syndrome[de.slideshare.net]
  • This explains why depressed individuals may be more susceptible to infection Other Regionalized Functions of the Hypothalamus the lateral hypothalamus is important in increasing appetite; lesions to this area cause a decrease in body weight the medial[brainaacn.org]
Headache
  • CONSUMERS: Click here for the Consumer Version Patients with hypothalamic-pituitary lesions generally present with some combination of Symptoms and signs of a mass lesion: headaches, altered appetite, thirst, visual field defects—particularly bitemporal[merckmanuals.com]
  • Other symptoms of a hypothalamic lesion include weight loss or gain, paleness, excessive sweating, tremor or shakiness, irritability, involuntary eye movements, euphoria, headaches that tend to be worse during the morning, and, in children, failure to[123helpme.com]
  • Patients with pituitary apoplexy present with sudden headache, meningeal signs, unilateral or bilateral cavernous sinus syndrome, visual loss, hypotension, and depressed level of consciousness.[brainaacn.org]
  • Women who are postmenopausal will not have obvious symptoms such as these and may first present with headache or loss of vision. Men may also suffer sexual dysfunction as a result of gonadotropin deficiency.[medical-dictionary.thefreedictionary.com]
  • In some cases, the obstruction seemed enough to cause abnormal accumulation of CSF within the ventricles (hydrocephalus). 5 Impaired CSF flow can generate conditions like severe headache, neurological injury or lethargy.[massagemag.com]
Lethargy
  • In some cases, the obstruction seemed enough to cause abnormal accumulation of CSF within the ventricles (hydrocephalus). 5 Impaired CSF flow can generate conditions like severe headache, neurological injury or lethargy.[massagemag.com]
  • […] nervousness, insomnia, weight loss, tremor, excessive sweating, poor temperature regulation, and frequent bowel movements thyroid opthalmopathy – inflammation of orbital tissues proximal muscle weakness, tremor, dyskinesias and dementia Hypothyroidism lethargy[brainaacn.org]
Atonic Seizures
  • He had also history of infantile spasms and atonic seizures since a similar period. Seizures responded poorly to antiepileptic treatment.[annalsofian.org]
Amenorrhea
  • Case Report Case Report American Journal of Neuroradiology September 2011, 32 (8) E153-E155; DOI: Abstract SUMMARY: This study describes a case of a patient with OSMS who presented with somnolence, periodic fever, memory impairment, and amenorrhea.[ajnr.org]
  • Página 82 - M. (1980): Pregnancies following chronic intermittent (pulsatile) administration of Gn-RH by means of a portable pump ("Zyklomat") - a new approach to the treatment of infertility in hypothalamic amenorrhea. ‎[books.google.es]
  • ., through the sphenoidal sinus, usually by means of pathway through the mouth and/or nose) prolactin secreting adenomas typically cause amenorrhea in women, hypogonadism in men, and galactorrhea, infertility, hair loss, decreased libido, and weight gain[brainaacn.org]
  • […] androgens and estrogens *other areas influence the production of sex hormones thorugh their regulation of anterior pituitary * before puberty * hypothalamic lesions-- may arret sexual development * after puberty * hypothalamic lesion s may result in amenorrhea[quizlet.com]
  • […] adenoma腺腫、アデノーマ adenomatous goiter腺腫様甲状腺腫 adrenal crisis副腎[急性]クリーゼ adrenal dysfunction副腎機能不全 adrenal gland副腎 adrenal gland adenoma副腎腺腫 adrenocorticotropic hormone(ACTH)副腎皮質刺激ホルモン adrenogenital syndrome副腎性器症候群 albuminuriaアルブミン尿 aldosteronismアルドステロン症 amenorrhea[tokyo-med.ac.jp]
Sexual Dysfunction

Workup

Hyperprolactinemia
  • Rarely, some children have adipsia without a definable structural lesion (essential adipsia). [9, 10, 11] A constellation of adipsia, obesity , hyperprolactinemia, and hypothyroidism was reported in one child. [11] In hypodipsia, the exact pathological[emedicine.medscape.com]
  • […] change Disease, diseased - see also Syndrome hypophysis E23.7 pituitary E23.7 (gland) Disorder (of) - see also Disease pituitary gland E23.7 Dysfunction hypophysis E23.7 Lesion (s) (nontraumatic) hypothalamic E23.7 ICD-10-CM Codes Adjacent To E23.7 E22.1 Hyperprolactinemia[icd10data.com]
Abnormal Thyroid Function Test
  • THYROID FUNCTION TEST 47 THYROID DISORDERS OF INFANCY 462 P A RT IV CALCIUM AND BONE METABOLISM 473 MORPHOLOGY OF THE PARATHYROID 51 PARATHYROID HORMONE 497 PHYSIOLOGY OF CALCIUM 52 PARATHYROID HORMONERELATED 512 CLINICAL APPLICATION OF BONE MINERAL[books.google.com]

Treatment

  • They play a vital role in planning and implementing treatment. As a neurosurgeon I am trained in the operative and non- operative diagnosis, management, prevention, and treatment of neurological disorders.[123helpme.com]
  • Rapidly consult with trusted authorities thanks to new expert-opinion treatment strategies and recommendations. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography.[books.google.de]
  • Patient remained seizure free with treatment. Last follow-up was done at about six months since start of therapy.[annalsofian.org]
  • Página 62 - Treatment of true precocious puberty with a potent luteinizing hormone-releasing factor agonist: Effect on growth, sexual maturation, pelvic sonography, and the hypothalamic-pituitary-gonadal axis. ‎[books.google.es]
  • Two years ago, she had diagnosed and after surgery, she has taken three cycles of cyclophosphamide adriamycin 5-flurourasil than three cycles dosetaxel and finally seventeen cycles herceptin treatment.[endocrine-abstracts.org]

Prognosis

  • If removal of the tumor was successful then the patient can expect a positive prognosis regarding recovery rate and expected mortality.[123helpme.com]
  • Prognosis The prognosis for most patients with hypopituitarism is excellent. As long as therapy is continued, many experience normal life spans.[medical-dictionary.thefreedictionary.com]
  • Long-term follow-up evaluation of magnetic resonance imaging in the prognosis of permanent GH deficiency. Eur J Endocrinol 2000 ; 143 : 493 –96 Carr DH, Sandler LM, Joplin GF. Computed tomography of sellar and parasellar lesions.[ajnr.org]

Etiology

  • We examined an obese 58-year-old patient with a bilateral posterior hypothalamic lesion of unknown etiology. A 24-hour polysomnography revealed a markedly increased total sleep time (17.6 h). During daytime, only 3 continuous wake phases occurred.[ncbi.nlm.nih.gov]
  • A genetic etiology has also been suggested. [14] Gelastic Seizure may also be observed in patients without MRI lesions and with normal neurologic status.[annalsofian.org]
  • Serum levels of pituitary hormones are lower than normal. hypopituitarism Endocrinology A condition characterized by secretion of one or more anterior pituitary or adenohypophyseal hormones Etiology Idiopathic, pituitary tumor, hypothalamic or infundibular[medical-dictionary.thefreedictionary.com]

Epidemiology

  • […] thyroid hormones 3.1.3 Clinical assessment of the thyroid patient 3.1.4 Thyroid function tests and the effects of drugs 3.1.5 Nonthyroidal illness 3.1.6 Thyroid imaging: nuclear medicine techniques 3.1.6.1 Thyroid imaging: nonisotopic techniques 3.1.7 Epidemiology[oxfordmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • Recently, it was discovered that the pathophysiology of idiopathic narcolepsy-cataplexy is linked to orexin ligand deficiency in the brain and cerebrospinal fluid.[ci.nii.ac.jp]
  • Hypothalamic dysfunction (hypothalamic syndromes) 2.4.2 Craniopharyngiomas 2.4.3 Perisellar tumours including cysts, hamartomas, and vascular tumours 2.4.4 Lymphocytic hypophysitis and other inflammatory conditions of the pituitary 2.5 Pineal physiology and pathophysiology[oxfordmedicine.com]

Prevention

  • As a neurosurgeon I am trained in the operative and non- operative diagnosis, management, prevention, and treatment of neurological disorders.[123helpme.com]
  • Prevention There is no known prevention of hypopituitarism, except for prevention of damage to the pituitary/hypothalamic area from injury. Key terms Adenoma — A benign (not threatening or cancerous) tumor that originates in a gland.[medical-dictionary.thefreedictionary.com]
  • […] polyphagia (polyphagy)多食[症]、過食[症] polyuria多尿 posterior pituitary(neurohypophysis)下垂体後葉 postprandial blood glucose食後血糖[値] postprandial hyperglycemia食後高血糖、食後過血糖 postprandial hypoglycemia食後低血糖 postprandial lipemia食後高脂血症 post-treatment neuropathy治療後神経障害 primary prevention[tokyo-med.ac.jp]
  • Date: Jul 2011 Print ISBN-13: 9780199235292 Published online: Jul 2011 DOI: 10.1093/med/9780199235292.001.1 Contents Front Matter Contributors Abbreviations Part 1 Principles of international endocrine practice 1.1 A brief history of endocrinology 1.2 Prevention[oxfordmedicine.com]
  • In general, we refer as “typical” to cases for which there is a record of food or body related preoccupations or rituals or when purging behaviour, food restriction, or hyperactivity are intended to cause weight loss or prevent weight gain in the absence[jnnp.bmj.com]

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