Disorders of the hypothalamus

These may be focal lesions, as in multiple sclerosis, tumours, or trauma, following surgery and the effects of radiotherapy. Excessive daytime sleepiness is associated with lesions of the posterior hypothalamus which increase the homeostatic sleep drive, but circa-dian rhythm disorders develop if the suprachiasmatic nuclei in the anterior hypothalamus are damaged. Hypothalamic lesions are often associated with endocrine and autonomic abnormalities and may also cause secondary narcolepsy.

There are several syndromes in which it is thought that diffuse hypothalamic abnormalities are the cause of excessive daytime sleepiness. The most important are described below.

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