Cold at the Core: Osborn Waves in Neurosarcoidosis-Induced Central Hypothermia

Osborn waves, or J waves, initially described by John Osborn in 1953 in hypothermic dog experiments, are highly sensitive and specific for hypothermia. Initially thought to be secondary to a hypothermia-induced "injury current," they have more recently been attributed to a voltage differential between epicardial and endocardial potassium (I_to) currents. While the exact conditions required to induce such waves have been debated, numerous clinical scenarios of environmental and iatrogenic hypothermia have been described. Below, we report a novel case of hypothermia-that of neurosarcoidosis-induced central hypothermia with resultant Osborn waves and other associated findings found on electrocardiogram (ECG).