Spontaneous periodic hypothermia in Parkinson disease with hypothalamic involvement

An 88-year-old woman with history of atrial fibrillation, hypertension, and hypothyroidism was hospitalized for repeated episodes of hypothermia over 4 years. Initial rare episodes of mild hypothermia and confusion in winter months progressed to more frequent and severe episodes. The patient was hospitalized at least 3 times at other facilities before presenting to our hospital with recurrent daily episodes. During these episodes, her body temperature dropped spontaneously, followed by confusion, dysarthria, bradycardia, hypercarbic respiratory failure, and hypoglycemia.