Low CSF hypocretin-1 levels in an adult patient with hypothalamic hamartoma.

Patients with hypothalamic hamartomas (HHs) located at the level of the mammillary bodies may present with a peculiar epileptic syndrome characterized by gelastic seizures and, commonly, falls.1–4 Associated symptoms can include developmental delay, cognitive deterioration, psychiatric disorders, central precocious puberty, and sleep disturbances.1,4–6 Here, we report the case of an adult patient with HH and excessive daytime sleepiness (EDS) in whom CSF analysis disclosed low levels of hypocretin-1, a finding consistently observed in patients with type 1 narcolepsy.7