Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Hypothermia and memory disturbance as initial manifestations associated with lesions of the diencephalon in a patient with anti-aquaporin 4 antibody-associated disorder: a case report

Tatsu Nakano, M.D., Ph.D.1), Fumi Dei, M.D.1), Yuko Kawamoto, M.D.1), Toshiyuki Takahashi, M.D., Ph.D.2), Fumiaki Tanaka, M.D., Ph.D.3) and Kazuo Koyama, M.D., Ph.D.1)

1)Department of Neurology, Fujisawa City Hospital
2)Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine
3)Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine

A 69-year-old woman was admitted due to gradual progression of daytime sleepiness and forgetfulness over a period of approximately 1 month. Bradycardia and hypothermia were observed on admission, and neurological examination revealed memory disturbance, mild dysarthria, and bradykinesia. Fluid-attenuated inversion recovery (FLAIR) images of the brain magnetic resonance imaging (MRI) indicated signal hyperintensity in the region bordering the lateral and third ventricles. Serum anti-aquaporin 4 (AQP4) antibody was detected. The patient had no history or findings of optic neuritis or myelitis, and she was diagnosed as anti-AQP4 antibody-associated disorder. Diencephalon lesion and/or symptoms are rarely observed at the onset of neuromyelitis optica. Differential diagnosis of this disorder is necessary in cases manifesting diencephalon symptoms or involving lesions bordering the third ventricle without evidence of previous optic neuritis or myelitis.
Full Text of this Article in Japanese PDF (2267K)

(CLINICA NEUROL, 54: 653|656, 2014)
key words: anti-aquaporin 4 antibody, hypothermia, neuromyelitis optica (NMO) spectrum disorder, diencephalon, memory disturbance

(Received: 30-Mar-13)