Hypersomnia Caused by Isolated Angiitis of the CNS

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  • NAKAJI Kayoko
    Department of Neurology, Kyoto University Graduate School of Medicine
  • IKEDA Akio
    Department of Neurology, Kyoto University Graduate School of Medicine
  • OKA Yasunori
    Department of Neurology, Kyoto University Graduate School of Medicine
  • TOMIMOTO Hidekazu
    Department of Neurology, Kyoto University Graduate School of Medicine
  • SHIMOHAMA Shun
    Department of Neurology, Kyoto University Graduate School of Medicine
  • KANBAYASHI Takashi
    Department of Neuropsychiatry, Akita University School of Medicine
  • SHIBASAKI Hiroshi
    Department of Neurology, Kyoto University Graduate School of Medicine Current address: NINDS, Takeda General Hospital, Kyoto

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Abstract

A 42-year-old woman presented gradual development of hypersomnia and memory disturbance. T2-weighted and FLAIR MRI scans revealed a high intensity abnormality in the hypothalamus. Stereotactic brain biopsy specimen revealed prominent infiltration of the lymphocytes in the vessel walls. Since there was no evidence of systemic angiitis, the diagnosis of isolated angiitis of the CNS (IAC) was made. Polysomnographic study showed decreased REM sleep and increased stage I sleep. Orexin A in the CSF was decreased. Hypersomnia and a decrease of the CNS orexin A improved after corticosteroid therapy. Hypersomnia can be an initial symptom of IAC if it involves the hypothalamus.

Journal

  • Internal Medicine

    Internal Medicine 44 (8), 883-885, 2005

    The Japanese Society of Internal Medicine

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