Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Characteristics of Episodic Hypothermia in MS

Mult Scler; ePub 2018 Mar 23; Toledano, et al

Episodic hypothermia (EH) occurs predominantly in patients with advanced secondary progressive multiple sclerosis (MS), according to a recent study, with the major manifestation being altered consciousness. Infection is often suspected as causal, but infrequently confirmed. Patients were identified through review of the Mayo Clinic electronic medical record (1996 to July 2015). Search terms were “multiple sclerosis” or “MS” within the diagnoses field and “hypothermia” within any field. Researchers reviewed records for accuracy of diagnoses and abstracted relevant data and magnetic resonance imaging (MRI) was reviewed for presence of hypothalamic lesions. They found:

  • Of 156 patients, 34 had concurrent MS and hypothermia.
  • 32 (94%) had progressive disease at EH onset.
  • Median MS duration was 19.9 years, and median Expanded Disability Status Scale (EDSS) was 8.0.
  • Most patients presented with alterations in consciousness.
  • Infection was suspected as the precipitating factor in 19 (56%), but clinically/laboratory supported in only 9 (28%).
  • MRI lesions were evident within the hypothalamus in only 4 (14%).


Toledano M, Weinshenker BG, Kaufmann TJ, Parisi JE, Paz Soldán MM. Demographics and clinical characteristics of episodic hypothermia in multiple sclerosis. [Published online ahead of print March 23, 2018]. Mult Scler. doi:10.1177/1352458518767045.

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