Hypothalamic-Midbrain Dysregulation Syndrome: Hypertension, Hyperthermia, Hyperventilation, and Decerebration

Certain decerebrate lesions of brain stem or hypothalamus induce pharmacologically reversible hypertension and hyperthermia in animals. We observed three young patients with episodic decerebration, hyperthermia, hypertension, and hyperventilation during recovery from comas of different etiologies. T...

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Bibliographic Details
Published in:Journal of child neurology 1991-04, Vol.6 (2), p.115-122
Main Authors: Pranzatelli, M.R., Pavlakis, S.G., Gould, R.J., De Vivo, D.C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brain Injuries - complications
Brain Injuries - physiopathology
Child
Coma - etiology
Decerebrate State - etiology
Fever - etiology
Humans
Hypertension - etiology
Hyperventilation - etiology
Hypothalamus - physiopathology
Male
Mesencephalon - physiopathology
Syndrome
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Summary:Certain decerebrate lesions of brain stem or hypothalamus induce pharmacologically reversible hypertension and hyperthermia in animals. We observed three young patients with episodic decerebration, hyperthermia, hypertension, and hyperventilation during recovery from comas of different etiologies. The shared pathology on neurologic examinations and computed tomographic scans was hypothalamic-mesencephalic dysfunction, suggesting a diencephalic-brain-stem disconnection syndrome or brain-stem release mechanism. Propranolol was the most effective drug tested, but only two patients responded, one dramatically. This novel clinical syndrome may have localizing and therapeutic significance in pediatric coma that needs to be further defined in future studies. (J Child Neurol 1991;6:115-122).
ISSN:0883-0738
1708-8283
DOI:10.1177/088307389100600204