The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index; none of the 12 sources its claims cite is checked for support yet.
Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome
Open accessAbstract
Recurrent hypothermia is an uncommon but clinically significant problem in adults with prior traumatic brain injury (TBI), such as shaken baby syndrome (SBS). Central thermoregulatory dysfunction, due to hypothalamic or autonomic injury, can lead to episodic hypothermia that mimics endocrine pathology. We describe a 38-year-old woman with cerebral palsy (CP) and a remote history of SBS presenting with recurrent hypothermia despite normal thyroid and adrenal function. Her episodes were initially treated empirically with corticosteroids, given concern for adrenal involvement, but recurrent events prompted multidisciplinary evaluation. Multiple infectious, endocrine, and neurologic assessments were negative for secondary causes. Imaging confirmed microcephaly and encephalomalacia consistent with prior TBI. Hypothermia was managed with supportive warming and steroid tapering. Neurology and endocrinology attributed her symptoms to hypothalamic hypoplasia or autonomic dysfunction resulting from her early brain injury. This case highlights the importance of recognizing central hypothermia as a long-term sequela of SBS to prevent unnecessary corticosteroid exposure and to improve supportive management.
Overview
CoChat Summary
TL;DR
A 38-year-old woman with cerebral palsy and a remote history of shaken baby syndrome had recurrent severe hypothermia despite normal thyroid and adrenal testing, ultimately attributed to central thermoregulatory dysfunction from early brain injury. Management focused on supportive warming and tapering unnecessary corticosteroids, which had been given empirically and contributed to insomnia.
Key findings
- Baseline temperature was chronically low, averaging 96.5°F, with acute episodes including 94°F at home and 92°F during sepsis; she required active external rewarming with a Bair Hugger.
- Endocrine causes were excluded: serum a.m. cortisol was 37.2, cosyntropin stimulation was unremarkable, and TSH was normal; infectious workups were also negative.
- Imaging confirmed microcephaly and encephalomalacia consistent with prior TBI, and the etiology table listed central thermoregulatory dysfunction as “Most likely,” with sepsis/infection, adrenal insufficiency, and hypothyroidism “Excluded” and drug-induced causes “Low likelihood.”
- Corticosteroid therapy was considered not indicated, was tapered/ceased, and was associated with insomnia; supportive measures included environmental temperature control, clothing, and temperature monitoring.
Methods
- Single-patient case report of a 38-year-old woman with CP, SBS, microcephaly with lissencephaly, VP shunt, seizure disorder, blindness, GERD, glaucoma, osteoporosis, PEG-tube dependence, and recurrent hypothermia.
- Data came from multiple hospital/ED admissions from October 2022 through October 2025, including infectious workups, endocrine testing, EEGs, CT head, and clinical response to warming and corticosteroids.
- Main analysis was descriptive differential diagnosis/exclusion of secondary causes; no formal statistical analysis or comparison group.
Limitations
- The paper does not include a formal limitations section (not stated).
- Evident from the text: this is a single case report, so findings are not generalizable and causal attribution to hypothalamic damage is inferred from imaging and exclusion rather than histopathologic confirmation.
- Evident from the text: the patient is nonverbal and cannot share her perspective, so management was influenced by caregiver observations, including subjective improvement with corticosteroids that was not supported by objective testing.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
0 Valid · 0 Not valid · 5 Not checked · 12 Own results and interpretations
A result the paper states — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The patient's baseline temperature is chronically low, averaging 96.5°F.”
§ Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome > Case presentation
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Imaging confirmed microcephaly and encephalomalacia consistent with prior TBI.”
§ Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome > Abstract
plainstates an associationSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption not shown here.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Multiple infectious, endocrine, and neurologic assessments were negative for secondary causes.”
§ Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome > Abstract
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption not shown here.
In the paper
“Damage to this region can impair the body's ability to perceive core temperature and mount appropriate physiological responses, leading to poikilothermia and a propensity for hypothermia [6].”
§ Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome > Introduction
What the sources say
- Not checked yetcites [6] Duong H, Patel G. Hypothermia. StatPearls Publishing, Treasure Island, USA; 2024.
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A statement the paper makes itself — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Central thermoregulatory dysfunction, due to hypothalamic or autonomic injury, can lead to episodic hypothermia that mimics endocrine pathology.”
§ Recurrent Severe Hypothermia as a Manifestation of Central Thermoregulatory Dysfunction in a Patient With Cerebral Palsy and Shaken Baby Syndrome > Abstract
plainstates a causeSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
5 more claims
Create a free account to see all 17 claims and to verify the 12 references still open.
- It may state two separate claims as one. 4
- Probably not a substantial claim. 3
Citations
Cites
A Population-Based Study of Inflicted Traumatic Brain Injury in Young Children
Keenan, H. T. (2003) · JAMA · doi:10.1001/jama.290.5.621 · Cited by 640
Annual incidence of shaken impact syndrome in young children
Barlow, K. M., & Minns, R. A. (2000) · The Lancet · doi:10.1016/s0140-6736(00)03130-5 · Cited by 371
Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model
Stallings, V., Zemel, B., Davies, J., Cronk, C., & Charney, E. (1996) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.4.627 · Cited by 170
Autonomic dysfunction syndromes after acute brain injury
(2015) · Handbook of Clinical Neurology · doi:10.1016/b978-0-444-63521-1.00034-0 · Cited by 65
Svedberg, L. E., Englund, E., Malker, H., & Stener-Victorin, E. (2008) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2007.06.004 · Cited by 30
Adjunctive topiramate enhances the risk of hypothermia associated with valproic acid therapy
Knudsen, J. F., Sokol, G. H., & Flowers, C. M. (2008) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1111/j.1365-2710.2008.00943.x · Cited by 30
Hypothermia associated with clobazam use in adult epilepsy
Gauthier, A. C., Quraishi, I. H., & Mattson, R. H. (2016) · Epilepsy & Behavior Case Reports · doi:10.1016/j.ebcr.2016.01.002 · Cited by 6
Verduzco-Mendoza, A., Mota-Rojas, D., Olmos Hernández, S. A., Gálvez-Rosas, A., Aguirre-Pérez, A., Cortes-Altamirano, J. L., Alfaro-Rodríguez, A., Parra-Cid, C., Avila-Luna, A., & Bueno-Nava, A. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1304440 · Cited by 6
Cited by
Still being checked.
Metadata
- Authors
- Allnutt, B., Petrasko, P., & Jacob, R.
- Affiliations
- University of Florida Health (US)
- University of Florida (US)
- Corresponding author
- Petrasko, Phillip
- ORCID
- Jacob, Rafik
- Venue
- Cureus
- Published
- 2026-01-26
- Volume
- 18
- Issue
- 1
- Pages
- e102330-e102330
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC12935388
- OpenAlex
- W7125716541
- Cited by
- 0
- References
- 8
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- shaken baby syndrome, cerebral palsy, traumatic brain injury, autonomic dysfunction, encephalomalacia, microcephaly, corticosteroid overuse
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
