시상하부를 침범한 다발성경화증 환자에서 발생한 증후성 기면증
Symptomatic Narcolepsy associated with Lesion of Hypothalamus in Multiple Sclerosis
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We report a rare case of multiple sclerosis(MS) with hypothalamic lesions. A 33-year-old man with long history of MS was admitted with acute hypersomnia. He did not have sleep paralysis, hypnagogic hallucination, or cataplexy. Brain MRI showed a new plaque in both hypothalamus and thalamus. Polysomnography revealed severe obstructive sleep apnea syndrome. On the multiple sleep latency test(MSLT), average sleep latency was 54 seconds and there were noted 3 SOREM(Sleep Onset REM) on 5 trial. His sleepiness improved following treatment with steroid and methylphenidate. 4 month later, follow-up polysomnography and MSLT were performed. There were no differences in API during full night polysomnography but no SOREM in MSLT was observed.
Abstract
We report a rare case of multiple sclerosis(MS) with hypothalamic lesions. A 33-year-old man with long history of MS was admitted with acute hypersomnia. He did not have sleep paralysis, hypnagogic hallucination, or cataplexy. Brain MRI showed a new plaque in both hypothalamus and thalamus. Polysomnography revealed severe obstructive sleep apnea syndrome. On the multiple sleep latency test(MSLT), average sleep latency was 54 seconds and there were noted 3 SOREM(Sleep Onset REM) on 5 trial. His sleepiness improved following treatment with steroid and methylphenidate. 4 month later, follow-up polysomnography and MSLT were performed. There were no differences in API during full night polysomnography but no SOREM in MSLT was observed.