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Central nervous system
Central nervous system


Definition:

Hypothalamic dysfunction is a problem with the region of the brain called the hypothalamus , which helps control the pituitary gland and regulate many body functions.



Causes, incidence, and risk factors:

The hypothalamus helps control the pituitary gland, particularly in response to stress. The pituitary, in turn, controls the:

The hypothalamus also helps regulate:

  • Body temperature
  • Childbirth
  • Emotions
  • Growth
  • Milk production
  • Salt and water balance
  • Sleep
  • Weight and appetite

Causes of hypothalamic dysfunction include:

  • Anorexia
  • Bleeding
  • Bulimia
  • Genetic disorders
  • Growths (tumors)
  • Head trauma
  • Infections and swelling (inflammation)
  • Malnutrition
  • Radiation
  • Surgery
  • Too much iron

The most common tumors in the area are craniopharyngiomas in children.



Symptoms:

Symptoms generally relate to the hormones that are missing. In children, there may be growth problems -- either too much growth or too little -- or puberty that occurs too early or too late.

Tumor symptoms:

  • Headaches
  • Loss of vision

Hypothyroidism symptoms:

  • Breast enlargement
  • Cold intolerance
  • Fatigue
  • Hair or skin changes
  • Impotence
  • Loss of body hair and muscle (in men)
  • Menstrual disturbance
  • Weight gain

Low adrenal function symptoms:

  • Dizziness
  • Weakness

Other, less common symptoms may include:

  • Body temperature disturbance
  • Emotional abnormalities
  • Excess thirst
  • Obesity
  • Uncontrolled urination

Kallmann's syndrome (a type of hypothalamic dysfunction that occurs in men) symptoms:

  • Lowered function of sexual hormones (hypogonadism )
  • Inability to smell


Signs and tests:

Blood or urine tests to determine levels of hormones such as:

Other possible tests:

  • Hormone injections followed by timed blood samples
  • MRI or CT scans of the brain
  • Visual field eye exam (if there is a tumor)


Treatment:

Treatment depends on the cause of the hypothalamic dysfunction.

  • Tumors -- surgery or radiation
  • Hormonal deficiencies -- replace missing hormones

Specific treatments may be available for bleeding, infection, and other causes.



Support Groups:



Expectations (prognosis):

Many causes of hypothalamic dysfunction are treatable. Most of the time missing hormones can be replaced.



Complications:

Complications of hypothalamic dysfunction depend on the cause.

Brain tumors:

  • Permanent blindness
  • Specific problems related to the brain area where the tumor occurs
  • Vision disorders

Hypothyroidism:

Adrenal insufficiency:

  • Inability to deal with stress (such as surgery or infection)

Gonadal deficiency:

Growth hormone deficiency:



Calling your health care provider:

Call your doctor if you have:

  • Headaches
  • Symptoms of hormone excess or deficiency
  • Vision problems


Prevention:

Maintain a healthy diet and don't exercise too strenuously or lose weight too quickly. If you believe you have an eating disorder such as anorexia or bulimia, get medical attention: these conditions can be life-threatening.

If you have symptoms of a hormonal deficiency, discuss replacement therapy with your health care provider.



References:

Low MJ. Neuroendocrinology. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 7.




Review Date: 3/18/2008
Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
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