Abstract
A 21-year-old woman was admitted due to altered mental status and hypothermia. The patient had a diagnosis of neuromyelitis optica (NMO) for 12 years and she was positive for serum anti-aquaporin 4 antibody. On admission, physical examination revealed coma with decerebration rigidity and poikilothermia. Magnetic resonance images of the brain revealed widespread, gadolinium enhancing lesions in the periventricular areas and the diencephalic structures. Laboratory investigations revealed hyponatremia and hypothyroidism. The patient was treated with high dose steroids. Both symptomatic and asymptomatic brain lesions may develop in patients with NMO. However, poikilothermia has not been reported in patients with NMO before.
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Wingerchuck DM, Hogancamp WF, O’Brien PC, Weinshenker BG (1999) The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 53:1107–1114
Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG (2006) Revised diagnostic criteria for neuromyelitis optica. Neurology 66:1485–1489
Cabrera-Gomez JA, Quevedo-Sotolongo L, Gonzalez-Quevedo A, Lima S, Real-González Y et al (2007) Brain magnetic resonance imaging findings in relapsing neuromyelitis optica. Multiple Scler 13:186–192
Pittock SJ, Weinshenker BG, Lucchinetti CF, Wingerchuk DM, Corboy JR et al (2006) Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression. Arch Neurol 63:964–968
Poppe AY, Lapierre Y, Melancon D, Lowden D, Wardell L et al (2005) Neuromyelitis optica with hypothalamic involvement. Mult Scler 11:617–621
Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR (2005) IgG marker of optic spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 202:473–477
MacKenzie MA, Hermus AR, Wollersheim HC, Pieters GF, Smals AG et al (1991) Poikilothermia in man: pathophysiology and clinical implications. Medicine (Baltimore) 70:257–268
Martin JB, Riskind PN (1992) Neurologic manifestations of hypothalamic disease. Prog Brain Res 93:31–40
Eichel R, Meiner Z, Abramsky O, Gotkine M (2008) Acute disseminating encephalomyelitis in neuromyelitis optica: closing the floodgates. Arch Neurol 65:267–271
Ito S, Mori M, Makino T, Hayakawa S, Kuwabara S (2009) “Cloud-like enhancement” is a magnetic resonance imaging abnormality specific to neuromyelitis optica. Ann Neurol 66:425–428
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Yildiz, O.K., Cevik, S. & Oztoprak, I. Consciousness disturbance and poikilothermia revealing brain involvement in neuromyelitis optica. Acta Neurol Belg 112, 213–215 (2012). https://doi.org/10.1007/s13760-012-0029-x
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DOI: https://doi.org/10.1007/s13760-012-0029-x