{{Infobox medical condition (new) | name = Hypothalamic disease | synonyms = | image = | caption = | pronounce = | field = Neurology, endocrinology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Hypothalamic disease''' is a disorder presenting primarily in the hypothalamus, which may be caused by damage resulting from malnutrition, including anorexia and bulimia eating disorders,<ref name="Asa">Sylvia L., A. (2004). Hypothalamic disease. In Editor-in-Chief: Luciano Martini (Ed.), ''Encyclopedia of endocrine diseases'' (pp. 678-687). New York: Elsevier. {{doi|10.1016/B0-12-475570-4/00714-9}}</ref><ref name="NIH">{{MedlinePlusEncyclopedia|001202|Hypothalamic dysfunction}}</ref> genetic disorders, radiation, surgery, head trauma,<ref>Rehan, K. (2011). An Overview of the Hypothalamus The Endocrine System’s Link to the Nervous System. Retrieved from http://www.endocrineweb.com/endocrinology/overview-hypothalamus</ref> lesion,<ref name="Asa" /> tumour or other physical injury to the hypothalamus. The hypothalamus is the control center for several endocrine functions. Endocrine systems controlled by the hypothalamus are regulated by antidiuretic hormone (ADH), corticotropin-releasing hormone, gonadotropin-releasing hormone, growth hormone-releasing hormone, oxytocin, all of which are secreted by the hypothalamus. Damage to the hypothalamus may impact any of these hormones and the related endocrine systems. Many of these hypothalamic hormones act on the pituitary gland. Hypothalamic disease therefore affects the functioning of the pituitary and the target organs controlled by the pituitary, including the adrenal glands, ovaries and testes, and the thyroid gland.<ref name="NIH" />
Numerous dysfunctions manifest as a result of hypothalamic disease. Damage to the hypothalamus may cause disruptions in body temperature regulation, growth, weight, sodium and water balance, milk production, emotions, and sleep cycles.<ref name="Asa" /><ref name="NIH" /><ref name="Carmichael">Carmichael, J. D., & Braunstein, G. D. (2009). Diseases of Hypothalamic Origin. In D. W. Pfaff, A. P. Arnold, S. E. Fahrbach, A. M. Etgen & R. T. Rubin (Eds.), ''Hormones, Brain and Behavior'' (3005-3048). Los Angeles, CA: Academic Press</ref> Hypopituitarism, neurogenic diabetes insipidus, tertiary hypothyroidism, and developmental disorders are examples of precipitating conditions caused by hypothalamic disease.
== Hypopituitarism == The hypothalamus and pituitary gland are tightly integrated. Damage to the hypothalamus will impact the responsiveness and normal functioning of the pituitary. Hypothalamic disease may cause insufficient or inhibited signalling to the pituitary leading to deficiencies of one or more of the following hormones: thyroid-stimulating hormone, adrenocorticotropic hormone, beta-endorphin, luteinizing hormone, follicle-stimulating hormone, and melanocyte–stimulating hormones. Treatment for hypopituitarism involves hormone replacement therapy.<ref name="Asa" />
== Neurogenic diabetes insipidus == Neurogenic diabetes insipidus may occur due to low levels of ADH production from the hypothalamus.<ref name="Asa" /><ref name="Rose" /><ref name="Maghnie">Maghnie, M., Altobelli, M., Di Iorgi, N., Genovese, E., Meloni, G., Manca-Bitti, M. L., . . . Bernasconi, S. (2004). Idiopathic central diabetes insipidus is associated with abnormal blood supply to the posterior pituitary gland caused by vascular impairment of the inferior hypophyseal artery system. ''The Journal of Clinical Endocrinology and Metabolism, 89''(4), 1891-1896.</ref> Insufficient levels of ADH result in increased thirst and urine output, and prolonged excessive urine excretion increases the risk of dehydration.<ref name="Maghnie" />
== Tertiary hypothyroidism == {{see also|Hypothalamic obesity}} The thyroid gland is an auxiliary organ to the hypothalamus-pituitary system. Thyrotropin-releasing hormone (TRH) produced by the hypothalamus signals to the pituitary to release thyroid-stimulating hormone (TSH), which then stimulates the thyroid to secrete T<sub>4</sub> and T<sub>3</sub> thyroid hormones.<ref name="Martin">Martin, J. B., & Riskind, P. N. (1992). Neurologic manifestations of hypothalamic disease. ''Progress in Brain Research, 93,'' 31-40; discussion 40-2.</ref><ref name="Chiamolera">Chiamolera, M. I., & Wondisford, F. E. (2009). Minireview: Thyrotropin-releasing hormone and the thyroid hormone feedback mechanism. ''Endocrinology, 150''(3), 1091-1096. {{doi|10.1210/en.2008-1795}}</ref> Secondary hypothyroidism occurs when TSH secretion from the pituitary is impaired, whereas tertiary hypothyroidism is the deficiency or inhibition of TRH.<ref name="Martin" />
Thyroid hormones are responsible for metabolic activity. Insufficient production of the thyroid hormones result in suppressed metabolic activity and weight gain. Hypothalamic disease may therefore have implications for obesity.<ref>Pinkney, J. (2000). Obesity and pituitary disease. ''Pituitary News, 17''. Retrieved from http://www.pituitary.org.uk/content/view/166/122/ {{Webarchive|url=https://web.archive.org/web/20120120220841/http://www.pituitary.org.uk/content/view/166/122/ |date=2012-01-20 }}</ref>
== Developmental disorders == Growth hormone-releasing hormone (GHRH) is another releasing factor secreted by the hypothalamus. GHRH stimulates the pituitary gland to secrete growth hormone (GH), which has various effects on body growth and sexual development.<ref name="Asa" /><ref name="Rose">Rose, S. R., & Auble, B. A. (2011). Endocrine changes after pediatric traumatic brain injury. ''Pituitary'', {{doi|10.1007/s11102-011-0360-x}}</ref> Insufficient GH production may cause poor somatic growth, precocious puberty or gonadotropin deficiency, failure to initiate or complete puberty, and is often associated with rapid weight gain, low T<sub>4</sub>, and low levels of sex hormones.<ref name="Rose" />
==Sleep disorders== Non-24-hour sleep-wake syndrome, a disabling condition in which one's sleep/wake cycle is longer, or rarely, shorter, than the standard 24 hours, is thought to involve or be caused by, at least in some cases, an abnormal functioning of the suprachiasmatic nucleus (SCN) in the hypothalamus.<ref name="Stores_2003">{{cite journal |author=Stores G |title= Misdiagnosing sleep disorders as primary psychiatric conditions |journal=Advances in Psychiatric Treatment |year=2003 |volume=9 |pages=69–77 |url=http://apt.rcpsych.org/cgi/content/full/9/1/69 |doi=10.1192/apt.9.1.69 |issue=1|doi-access=free }}</ref><ref>{{cite journal |author=Stores G |title=Clinical diagnosis and misdiagnosis of sleep disorders |journal=J. Neurol. Neurosurg. Psychiatry |volume=78 |issue=12 |pages=1293–7 |year=2007 |pmid=18024690 |doi=10.1136/jnnp.2006.111179 |pmc=2095611}}</ref>
== References == {{Reflist}}
== External links == {{Medical resources | DiseasesDB = | ICD10 = {{ICD10|E23.3}} | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D007027 }} {{Hypothalamic disease}}
Category:Hypothalamus disorders