Régis Lopez1, Lucie Barateau2, Sofiene Chenini2, Yves Dauvilliers3. 1. Service de Neurologie, Hôpital Gui-de-Chauliac, CHU, Montpellier, France; Centre de Référence Nationale Maladie Rare, Narcolepsie et Hypersomnie Idiopathique, Montpellier, France; Inserm U1061, Montpellier, France. 2. Service de Neurologie, Hôpital Gui-de-Chauliac, CHU, Montpellier, France; Centre de Référence Nationale Maladie Rare, Narcolepsie et Hypersomnie Idiopathique, Montpellier, France. 3. Service de Neurologie, Hôpital Gui-de-Chauliac, CHU, Montpellier, France; Centre de Référence Nationale Maladie Rare, Narcolepsie et Hypersomnie Idiopathique, Montpellier, France; Inserm U1061, Montpellier, France. Electronic address: ydauvilliers@yahoo.fr.
Abstract
OBJECTIVE: To measure CSF biomarkers of hypothalamic dysfunction in patients with typical Kleine-Levin syndrome (KLS) during symptomatic and asymptomatic periods. PATIENTS/ METHODS: Two patients with typical KLS were admitted during symptomatic and asymptomatic periods to a research Sleep Disorders Center. Cerebrospinalfluid (CSF) hypocretin-1, histamine (HA), and its major metabolite tele-methylhistamine (t-MHA) levels were measured in two KLS patients in and out of episode. RESULTS: CSF biomarkers of hypothalamic dysfunction measured in two KLS patients in and out of episode revealed low hypocretin levels (within the narcolepsy-cataplexy range) during a hypersomnia episode in the more severe patient, and a 42% decrease (although within normal range) in the second patient. CSF HA and t-MHA measurements in and out of episode revealed a two-fold in-episode decrease in HA in the more severe patient, with no significant change for the second patient, nor for t-MHA levels. CONCLUSION: We reported reversible changes in CSF hypothalamic biomarkers in a typical patient with KLS that reinforces the hypothesis that in some patients KLS episodes may be caused by recurrent functional alterations of the hypothalamus.
OBJECTIVE: To measure CSF biomarkers of hypothalamic dysfunction in patients with typical Kleine-Levin syndrome (KLS) during symptomatic and asymptomatic periods. PATIENTS/ METHODS: Two patients with typical KLS were admitted during symptomatic and asymptomatic periods to a research Sleep Disorders Center. Cerebrospinalfluid (CSF) hypocretin-1, histamine (HA), and its major metabolite tele-methylhistamine (t-MHA) levels were measured in two KLS patients in and out of episode. RESULTS: CSF biomarkers of hypothalamic dysfunction measured in two KLS patients in and out of episode revealed low hypocretin levels (within the narcolepsy-cataplexy range) during a hypersomnia episode in the more severe patient, and a 42% decrease (although within normal range) in the second patient. CSF HA and t-MHA measurements in and out of episode revealed a two-fold in-episode decrease in HA in the more severe patient, with no significant change for the second patient, nor for t-MHA levels. CONCLUSION: We reported reversible changes in CSF hypothalamic biomarkers in a typical patient with KLS that reinforces the hypothesis that in some patients KLS episodes may be caused by recurrent functional alterations of the hypothalamus.
Authors: Matthew S Thimgan; Cristina Toedebusch; Jennifer McLeland; Stephen P Duntley; Paul J Shaw Journal: Mediators Inflamm Date: 2015-03-22 Impact factor: 4.711
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