Hyperhidrosis Probably due to Hypothalamic Involvement in Multiple Sclerosis: A Case Report TING-KAI LEUNG HSIN-WEN CHEN CHAU-CHIN LEE SHOU-BIN CHOU CHANG-MING LING SEA-KIAT LEE PAU-NYEN CHONG

We report a 37-year-old female patient presented initially with typical radiological and clinical manifestations of multiple sclerosis (MS). She was found to have blurred vision and paresthesia. Later, she suffered from lower limbs weakness, general fatigue, difficulty swallowing, intentional tremor and urinary retention. At the same period, the patient was also found to have hyperhidrosis, which was not a typical sign of MS. After MR imaging revealed that there was a high signal lesion on T2WI at right hypothalamus which eventually involved the contralateral side of hypothalamus, the previous diagnosis became controversial. MS is a progressive demyelination disease, the most frequent affected sites in brain are periventricular white matter, corpus callosum or centrum semiovale. It was thought MS plaque was rarely found in hypothalamus. By reviewing articles in English literature, we found similar cases of multiple sclerosis involving hypothalamus and one of them was presented as hyperhidrosis.