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February 1946

DISTURBANCES IN SLEEP MECHANISM: A CLINICOPATHOLOGIC STUDYIII. LESIONS AT THE DIENCEPHALIC LEVEL (HYPOTHALAMUS)

Author Affiliations

NEW YORK; MEDICAL CORPS, ARMY OF THE UNITED STATES

From the Neuropsychiatric Service and the Neuropathological Laboratory of the Montefiore Hospital, and the Neurological Department of Columbia University College of Physicians and Surgeons.

Arch NeurPsych. 1946;55(2):111-125. doi:10.1001/archneurpsyc.1946.02300130037002
Abstract

In contrast to the questionable effect of cortical lesions on the sleep mechanism, it is well known that discrete diencephalic lesions, especially in the hypothalamus, are accompanied with disturbances in sleep. There is a wealth of clinical and experimental evidence that the hypothalamus acts as a sleep-regulating center. Conclusions regarding the relationship of anatomic lesions in the hypothalamus to precise disturbances in function should be made with reservation, because areas adjacent to the hypothalamus, such as the thalamus and the basal ganglia, may also be involved by compression or edema. We wish to emphasize that in many of the reported cases, as in some of ours, the lesions were widespread. The 17 cases to be described and the recently recorded experimental data of Harrison, Magoun and Ranson1 may help in the clarification of these intricate problems. We shall attempt to demonstrate that in a few of our cases the

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