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Which neurologic conditions cause hypothermia?
Experimental studies suggest that lesions of the anterior hypothalamus cause hyperthermia, lesions of the posterior hypothalamus cause hypothermia, and lesions of the suprachiasmatic nucleus cause alteration in the circadian rhythm of temperature.
Tumors and degenerative and inflammatory processes involving the hypothalamus may produce hypothermia (core body temperature below 35° C).
Wernicke’s encephalopathy
This disorder cause hypothermia by damaging the posterolateral hypothalamus and the floor of the fourth ventricle, may present with continuous hypothermia.
Prompt treatment with thiamine results in normalization of temperature.
Paroxysmal hypothermia with hyperhidrosis (PHH)
This is a syndrome manifested as episodic hypothermia, lasting between 30 minutes and 2 hours, associated with excessive sweating.
PHH is probably caused by a low core temperature set in the hypothalamus and is mostly seen in a Shapiro’s syndrome (agenesis of the corpus callosum).
The underlying mechanism of this syndrome is largely unknown, but disturbances in the function of ion channels may play a role in its pathogenesis.
Cyproheptadine, clonidine, chlorpromazine, and peripheral muscarinic agents such as oxybutynin or oxypyrrolate may control hypothermia and diaphoresis.
Episodic spontaneous hypothermia
This condition is a rare periodic childhood syndrome with no known systemic cause or underlying brain lesion.
Manifestations include episodic hypothermia (<35° C), marked facial pallor, and absent shivering.
Some patients may have bradycardia and hypertension.
It is believed that this childhood periodic syndrome is related to migraines.
