96 - Diseases of Hypothalamic Origin

Abstract

The hypothalamus integrates stimuli from a wide array of sources to control multiple behavioral, metabolic, and autonomic functions. Disruption of normal hypothalamic processes can result in altered water metabolism, temperature regulation, appetite control, sleep–wake cycles, circadian rhythms, and autonomic function. It is involved in memory, emotional expression, and behavior. The hypothalamus is also essential for control of anterior pituitary function, and abnormalities of the hypothalamus can result in both hyperfunction and hypofunction of the pituitary. Multiple etiologies can cause hypothalamic dysfunction, including congenital defects, tumors, infiltrative diseases, metabolic disturbances, infection, trauma, vascular insults, and irradiation. Patients with syndromes such as Prader–Willi, psychosocial short stature, and septo-optic dysplasia manifest multiple hypothalamic alterations. Hypothalamic hamartomas, germ cell tumors, gliomas, and craniopharyngiomas commonly disrupt normal hypothalamic functioning, and attempts to treat these lesions often result in persistent hypothalamic deficits. Critical illness, traumatic brain injury, and cranial irradiation have become more recognized etiologies of hypothalamic dysfunction requiring hormonal replacement.