Medical expert of the article
New publications
Symptoms of hypothalamic lesions
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
The hypothalamus is the bottom of the brain ventricle and consists of a cluster of highly differentiated nuclei (32 pairs). There are three groups of hypothalamic nuclei - anterior, middle and posterior.
The anterior part of the hypothalamus includes the paraventricular supraoptic nuclei; the middle part includes the posterior parts of the supraoptic nuclei, nuclei of the central gray matter of the ventricle, mammillofungular (anterior part), pallidoinfundibular, interfornical nuclei; the posterior part includes the mammillary body, mammillofungular nuclei (posterior part), and subthalamic nucleus. The anterior parts of the hypothalamus are related to the integration of the predominantly parasympathetic autonomic nervous system, the posterior parts are related to the sympathetic system, and the middle parts provide regulation of the endocrine glands and metabolism.
The subthalamic region is also distinguished in the hypothalamus, including the subthalamic nucleus, the indefinite zone, Forel's fields (H 1 and H 2 ) and some other formations. In functional terms, the subthalamic region is part of the extrapyramidal system. In the lower part of the hypothalamus are the gray tubercle and the funnel, which ends in the lower appendage of the brain - the pituitary gland. In the pituitary gland, there is an anterior zone (adenohypophysis), a posterior lobe (neurohypophysis) and an intermediate part, located in the form of a border in the posterior part of the anterior lobe.
The hypothalamus is an important vegetative center and has rich connections with the vegetative nuclei of the medulla oblongata, the reticular formation of the brainstem, the pituitary gland, the pineal gland, the gray matter around the ventricle and cerebral aqueduct, the thalamus, the striopallidal system, the olfactory brain, the limbic cortex of the brain, etc.
Being an important part of the limbic-reticular complex, the hypothalamus influences all vegetative-visceral functions of the body. It participates in the regulation of sleep and wakefulness, body temperature, tissue trophism, respiratory, cardiovascular system, hematopoiesis and blood coagulation system, acid-base state of the gastrointestinal tract, all types of metabolism, function of striated muscles, function of endocrine glands, sexual sphere. The hypothalamus is intimately connected with the pituitary gland, secretes, releases biologically active substances into the blood.
The hypothalamus plays an important role in the vegetative support of various forms of somatic and mental activity of a person. Therefore, damage entails not only vegetative-visceral, but also vegetative-somatic and vegetative-mental disorders.
When the hypothalamus is damaged, symptoms of failure in the regulation of various vegetative functions occur. Symptoms of irritation are most often observed, which manifest themselves in the form of paroxysmal states (crises, attacks). The nature of these paroxysmal disorders is predominantly vegetative-visceral.
Symptoms of hypothalamic damage are extremely varied. Sleep and wakefulness disorders manifest themselves in the form of paroxysmal or permanent hypersomnia, sleep formula distortion, and dyssomnia.
Vegetative-vascular syndrome (dystonia) is characterized by paroxysmal sympathetic-adrenal, vagus-insular and mixed sympathovagal crises with asthenic syndrome.
Neuroendocrine syndrome with plurigenital dysfunction is characterized by various endocrine disorders that are combined with neurotrophic disorders (thinning and dry skin, gastrointestinal ulcers), changes in bones (osteoporosis, sclerosis) and neuromuscular disorders in the form of periodic paroxysmal paralysis, muscle weakness, and hypotension.
Among neuroendocrine disorders, the following are characteristic: Itsenko-Cushing syndrome, adiposogenital dystrophy, dysfunction of the sex glands, diabetes insipidus, cachexia.
In Itsenko-Cushing syndrome, fat is deposited in the face ("moon face"), neck, shoulder girdle ("bull" type of obesity), chest, and abdomen. The limbs look thin against the background of obesity. Trophic disorders are observed in the form of stretch marks on the skin of the inner surface of the axillary areas, the lateral surface of the chest and abdomen, in the area of the mammary glands, buttocks, and also in the form of dry skin. Persistent or transient increase in blood pressure, changes in the sugar curve (flattened, two-humped curve), a decrease in the content of 17-corticosteroids in the urine are revealed.
Adiposogenital dystrophy (Babinski-Frohlich disease): pronounced fat deposition in the abdomen, chest, thighs, often clinodactyly, changes in the skeletal system, underdevelopment of the genitals and secondary sexual characteristics; trophic changes in the skin in the form of thinning, vulgaris, marbling, depigmentation, increased capillary fragility.
Lawrence-Moon-Biedl syndrome is a congenital developmental anomaly with dysfunction of the hypothalamic region, characterized by obesity, underdevelopment of the genitals, dementia, growth retardation, pigmentary retinopathy, polydactyly (syndactyly), and progressive vision loss.
Premature puberty (pubertas praecox) can be caused by a tumor of the mammillary bodies of the posterior hypothalamus or pineal gland. It is more common in girls with accelerated body growth. Along with premature puberty, bulimia, polydipsia, polyuria, obesity, sleep and thermoregulation disorders, mental disorders (emotional-volitional disorder with moral-ethical deviations, hypersexuality) are observed; such patients become rude, spiteful, cruel, with a tendency to vagrancy and theft.
Delayed puberty in adolescence is more common in boys. Characteristic features include tall stature, disproportionate body build, female-type obesity, hypoplasia of the genitals, cryptorchidism, monorchism, hypospadias, and gynecomastia. In girls, there is a delay in menarche, underdevelopment of the genitals, and absence of secondary hair growth. Puberty in adolescents is delayed until the age of 17-18.
Diabetes insipidus develops as a result of decreased production of antidiuretic hormone by neurosecretory cells of the supraoptic and paraventricular nuclei: polydipsia, polyuria (with a relatively low relative density of urine).
Cerebral dwarfism is characterized by slow physical development: dwarfism, short and thin bones, small head size and reduced size of the sella turcica; external genitalia are hypoplastic.
With foci in one half of the hypothalamus, vegetative asymmetry is detected: skin temperature, sweating, piloerection, blood pressure, pigmentation of the skin and hair, hemiatrophy of the skin and muscles.
When the metathalamus is affected, hearing and vision are impaired (homonymous hemnanopsia) due to dysfunction of the external and internal geniculate bodies.
With eosinophilic adenoma of the pituitary gland with excessive secretion of growth hormone or with increased stimulation of the adenohypophysis by the somatotropin-releasing hormone of the hypothalamus, acromegaly develops: the hands, feet, facial skeleton, internal organs increase in size, and metabolism is disrupted.
[