Orexin secretion abnormality involved in excessive somnolence in CNS lymphoma without hypothalamic lesions

Yasuhiro Hamada; Tadayuki Takata; Rie Kawakita; Hideki Kobara; Masaki Okada; Takashi Tamiya; Takashi Kanbayashi; Tetsuo Touge; Kazushi Deguchi; Tsutomu Masaki

doi:10.1016/j.jocn.2019.03.066

Orexin secretion abnormality involved in excessive somnolence in CNS lymphoma without hypothalamic lesions

J Clin Neurosci. 2019 Jun:64:6-7. doi: 10.1016/j.jocn.2019.03.066. Epub 2019 Apr 5.

Authors

Affiliations

¹ Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
² Department of Neurosurgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
³ Department of Neuropsychiatry, Akita University School of Medicine, 1-1-1 Hondo, Akita City, Akita 010-0000, Japan.
⁴ Department of Health Sciences, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
⁵ Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. Electronic address: kdeguchi@med.kagawa-u.ac.jp.

PMID: 30962060
DOI: 10.1016/j.jocn.2019.03.066

Abstract

A 72-year-old woman developed excessive somnolence as one of the symptoms of diffuse large B-cell lymphoma in the central nervous system (CNS). Although somnolence might be caused by reduced orexin secretion associated with hypothalamic lesions, neither brain MRI nor 18F-fluorodeoxyglucose positron emission tomography identified hypothalamic lesions. However, the decreased cerebrospinal fluid (CSF) orexin levels recovered to near normal values with improvement of somnolence after chemotherapy. The alteration of CSF orexin levels suggested the involvement of potential hypothalamic lesions. Therefore, measurements of CSF orexin levels may be useful for understanding the pathological background of somnolence in CNS lymphoma without hypothalamic lesions.

Keywords: Cerebrospinal fluid; Hypersomnia; Hypocretin-1; Lymphoma; Narcolepsy; Orexin.

Publication types

Case Reports

MeSH terms

Aged
Central Nervous System Neoplasms / cerebrospinal fluid
Central Nervous System Neoplasms / complications*
Central Nervous System Neoplasms / pathology
Disorders of Excessive Somnolence / etiology*
Female
Humans
Lymphoma, Large B-Cell, Diffuse / cerebrospinal fluid
Lymphoma, Large B-Cell, Diffuse / complications*
Lymphoma, Large B-Cell, Diffuse / pathology
Orexins / cerebrospinal fluid*

Substances

HCRT protein, human
Orexins