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NEUROLOGY 2004;62:138-140
© 2004 American Academy of Neurology
Brief Communications

Hypocretin-1 CSF levels in anti-Ma2 associated encephalitis

S. Overeem, MSc PhD, J. Dalmau, MD PhD, L. Bataller, MD, S. Nishino, MD PhD, E. Mignot, MD PhD, J. Verschuuren, MD PhD and G. J. Lammers, MD PhD

From the Department of Neurology (Drs. Overeem, Verschuuren, and Lammers), Leiden University Medical Centre, the Netherlands; Department of Neurology (Dr. Dalmau), University of Pennsylvania, Philadelphia; Department of Neurology (Dr. Bataller), University Hospital La Fe, Valencia, Spain; and Department of Psychiatry & Behavioral Sciences (Drs. Nishino and Mignot), Stanford University Center for Narcolepsy, Palo Alto, CA.

Address correspondence and reprint requests to Dr. G.J. Lammers, Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands; e-mail: G.J.Lammers{at}lumc.nl

Idiopathic narcolepsy is associated with deficient hypocretin transmission. Narcoleptic symptoms have recently been described in paraneoplastic encephalitis with anti-Ma2 antibodies. The authors measured CSF hypocretin-1 levels in six patients with anti-Ma2 encephalitis, and screened for anti-Ma antibodies in patients with ideopathic narcolepsy. Anti-Ma autoantibodies were not detected in patients with idiopathic narcolepsy. Four patients with anti-Ma2 encephalitis had excessive daytime sleepiness; hypocretin-1 was not detectable in their cerebrospinal fluid, suggesting an immune-mediated hypocretin dysfunction.

Received February 17, 2003. Accepted in final form September 8, 2003.




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