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09:29
Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4
Published on: August 21, 2017
Hypocretinergic dysfunction in neuromyelitis optica with coma-like episodes
B Carlander1, T Vincent, A Le Floch
1Department of Neurology, Hôpital Gui-de-Chauliac, Montpellier, France.
BMJ Case Reports
|June 21, 2011
Summary
Devic's neuromyelitis optica (NMO), a CNS demyelinating disease, can present with severe dysautonomia and hypersomnia. A case study revealed a significant drop in hypocretin/orexin levels in cerebrospinal fluid during NMO relapses.
Area of Science:
- Neuroimmunology
- Neurology
- Sleep Medicine
Background:
- Devic's neuromyelitis optica (NMO) is a severe autoimmune demyelinating disease targeting the central nervous system (CNS).
- NMO primarily affects the optic nerves and spinal cord, and is often misdiagnosed as multiple sclerosis.
- Dysautonomia and hypersomnia are less common but significant symptoms that can occur in NMO patients.
Purpose of the Study:
- To report a unique case of relapsing NMO with severe dysautonomia and hypersomnia.
- To investigate the association between NMO relapses and hypocretin/orexin levels in cerebrospinal fluid (CSF).
Main Methods:
- Case report detailing clinical presentation, diagnostic workup, and treatment of a patient with relapsing NMO.
- Cerebrospinal fluid (CSF) analysis including hypocretin/orexin level measurement.
Main Results:
- The patient experienced recurrent episodes of severe dysautonomia and hypersomnia coinciding with NMO relapses.
- A dramatic decrease in CSF hypocretin/orexin levels was observed during these relapses.
- Hypocretin/orexin levels showed partial recovery between relapses.
Conclusions:
- This case suggests a potential link between hypocretin/orexin system dysfunction and NMO relapses, particularly those involving severe dysautonomia and hypersomnia.
- Further research is warranted to explore the role of hypocretin/orexin in the pathophysiology of NMO.
- Monitoring hypocretin/orexin levels may offer insights into NMO disease activity and management.
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