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Hypothalamic lesions in multiple sclerosis
  1. Wei Qiu1,2,3,
  2. Sonja Raven4,
  3. Jing-Shan Wu1,2,
  4. Christine Bundell5,
  5. Peter Hollingsworth5,
  6. William M Carroll1,2,
  7. Frank L Mastaglia1,2,
  8. Allan G Kermode1,2
  1. 1Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, Western Australia, Australia
  2. 2Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
  3. 3Department of Neurology, The Third Affiliated Hospital of Sun yat-sen University, Guangzhou, PR China
  4. 4Neurointerventional and Imaging Services of Western Australia, Perth, Western Australia, Australia
  5. 5Department of Clinical Immunology, PathWest, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
  1. Correspondence to Professor Allan G Kermode, Australian Neuromuscular Research Institute, Sir Charles Gairdner Hospital, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Queen Elizabeth II Medical Centre, Perth, WA 6009, Australia; kermode{at}me.com

Abstract

Objectives To determine the frequency of hypothalamic lesions in patients with multiple sclerosis (MS) using conventional MRI (cMRI) protocols.

Methods Brain cMRI (1.5 Tesla) scans of 105 Caucasian patients with classical MS (50 with stable and 55 with more active disease) and 12 patients with longitudinal extensive myelopathy (LEM) were reviewed retrospectively. NMO-IgG antibody was assayed in patients with hypothalamic lesions.

Results Hypothalamic lesions were found in 13.3% of MS patients and in none of the LEM patients. A higher frequency of hypothalamic lesions was found in patients with active MS (18.2%) than in the stable group (8.0%), but this did not reach statistical significance (p=0.13). Patients with hypothalamic lesions also had more lesions in other cerebral structures. None of the LEM patients had hypothalamic lesions. No patients with hypothalamic lesions were positive for NMO-IgG.

Conclusions Hypothalamic lesions in MS are more frequent than previously reported and are not associated with NMO-IgG antibody.

  • Hypothalamus
  • multiple sclerosis
  • MRI
  • neuromyelitis optica
  • NMO-IgG

https://doi.org/10.1136/jnnp.2009.198192

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    Footnotes

    • Funding WQ was supported by an Endeavour International Postgraduate Research Scholarship (EIPRS) and Postgraduate Award from University of Western Australia. J-SW was supported by a Medical Postgraduate Scholarship from the National Health and Medical Research Council of Australia and Multiple Sclerosis Research Australia.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics approval was provided by Sir Charles Gairdner Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.