{
  "abstract": "Background\n\nSleep and wakefulness regulation is mediated by distributed interactions among thalamocortical circuits, hypothalamic orexinergic systems, and brainstem modulatory networks. Although the Edinger-Westphal nucleus is traditionally associated with parasympathetic pupillary control, its potential contribution to sleep and wakefulness regulation remains incompletely understood.Case presentation\n\nWe report a case of a 58-year-old male patient with excessive daytime sleepiness, bilateral ptosis with mydriasis (pupil diameter 6.0 mm), and complete loss of both direct and consensual light reflexes. The symptoms of hypersomnia disappeared and 24-hour polysomnography result was partially improved, with exception of still absence of stage 3 non-rapid eye movement sleep one month later. There was no improvement in the symptoms of oculomotor nerve paralysis and mydriasis.Conclusion\n\nThalamic and hypothalamic lesions can produce severe but partially reversible hypersomnia, likely mediated through disruption of thalamocortical and orexinergic systems. Midbrain involvement results in persistent oculomotor dysfunction. This case highlights the importance of distributed network interactions in sleep and wakefulness regulation and should be interpreted cautiously with regard to the specific role of the Edinger-Westphal nucleus.",
  "abstract_shown": true,
  "affiliations": [
    "Sleep Center, Department of Neurology, the First Hospital of Jilin University, Changchun, China.",
    "Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun, China.",
    "Sleep Center, Department of Neurology, the First Hospital of Jilin University, Changchun, China. wangzan@jlu.edu.cn.",
    "Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun, China. wangzan@jlu.edu.cn."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yanan Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ruiqi Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Qingqing Sun"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Lijia Cai"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jun Lu"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Zan Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7fxxzq0z8cfgg.bib",
  "cited_by": 0,
  "doi": "10.1186/s12883-026-05243-3",
  "fulltext_url": "https://europepmc.org/articles/PMC13729538",
  "id": "7fxxzq0z8cfgg",
  "issns": [
    "1471-2377"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972297",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2805|Sleep and Wakefulness Research"
    ]
  ],
  "openalex": "W7196964468",
  "pdf_url": "https://europepmc.org/articles/PMC13729538?pdf=render",
  "pmcid": "PMC13729538",
  "pmid": "42972297",
  "published": "2026-08-06",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/7fxxzq0z8cfgg.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42972297",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972297"
    },
    {
      "first_seen": "2026-11-07T12:22:16Z",
      "native_id": "PMC13729538",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12883-026-05243-3"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2805|Sleep and Wakefulness Research",
      "subfield": "neuroscience"
    }
  ],
  "title": "Excessive daytime sleepiness caused by multiple focal strokes in thalamus, hypothalamus, and Edinger-Westphal nucleus: a case report.",
  "title_text": "Excessive daytime sleepiness caused by multiple focal strokes in thalamus, hypothalamus, and Edinger-Westphal nucleus: a case report.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:16Z",
  "url": "https://research.draconitic.com/paper/7fxxzq0z8cfgg",
  "venue": "BMC neurology",
  "versions": []
}