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Lateral hypothalamic demyelination and cachexia in a case of "malignant" multiple sclerosis

Department of Pathology (Neuropathology), University of Wisconsin Medical School (Drs. Kamalian and ZuRhein), and the Department of Psychology, College of Letters and Sciences, University of Wisconsin (Dr. Keesey), Madison.

A 41-year-old woman had profound weight loss and cachexia as a manifestation of rapidly fatal multiple sclerosis. Demyelinating lesions were present in the lateral hypothalamus. Data from animal experiments have indicated that lateral hypothalamic lesions cause a weight loss associated with a lowering of the regulation level or "set-point" for body weight. This case suggests, therefore, that a rapid decline in the level of maintained body weight in a patient without pituitary disease or general organic disorder, or distinct emotional disorder, may represent a clinical manifestation of tissue injury of the lateral hypothalamus.

This work was supported by the Detling Fund, University of Wisconsin Medical School and by grant NS 11129 from the U.S. Public Health Service.

Received for publication August 7, 1974.

Requests for reprints should be addressed to Dr. ZuRhein, Department of Pathology, University of Wisconsin Medical School, 470 North Charter Street, Madison, WI 53706. Dr. Kamalian's present address is Department of Pathology, Faculty of Medicine, Teheran, Iran.

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