tayanex.blogg.se - Cataplexy with narcolepsy

CATAPLEXY WITH NARCOLEPSY PLUS

Patients should be treated in consultation with a sleep specialist.Medical therapy Principles of medical therapy State regulations vary on the legally required period of time that patients should be symptom-free before driving. Īs motor vehicle collisions are a concern for patients with narcolepsy, to be allowed to drive, they should be symptom-free and taking treatment. Consider scheduled naps throughout the day to reduce the urge to sleep.Avoid substances that disturb the sleep-wake cycle (e.g., alcohol, antipsychotics, opiates).Ensure regular sleep periods during the night.Human leukocyte antigen ( HLA) haplotype testing: not usually useful for diagnostic purposes.MRI brain: Consider if neurological findings suggest secondary narcolepsy.Supportive finding: decreased CSF hypocretin -1 ( orexin A) levels ( ≤ 110 pg/mL or Not routinely indicated may be used to diagnose type 1 narcolepsy.If feasible, medications affecting sleep (e.g., antidepressants and stimulants) should be paused for at least two weeks prior to a sleep study. Used to exclude other sleep disorders and may also show supportive findings for narcolepsy (e.g., SOREMP).Measures sleep duration, efficiency, and stages.Sleep-onset REM periods (SOREMPs): REM periods that occur within 15 minutes of falling asleep also referred to as shortened REM sleep latency.Sleep latency: time needed to fall asleep.Includes 5 opportunities for the patient to nap during the daytime and measures :.Daytime multiple sleep latency test (MSLT).In type 2 narcolepsy: characteristic findings on a sleep study without cataplexy or reduced hypocretin levels.OR low CSF hypocretin-1 ( orexin A) levels.

CATAPLEXY WITH NARCOLEPSY PLUS

≥ 1 episode of cataplexy PLUS characteristic findings on a sleep study.Daily periods of excessive daytime sleepiness for ≥ 3 months AND.Order sleep studies to confirm the diagnosis and refer to sleep medicine.Assess for cataplexy based on patient history and third-party reports.Recommend a sleep log for 1–2 weeks and/or actigraphy.Consider using a sleep questionnaire, e.g., the Epworth sleepiness scale.Rule out other causes of EDS, e.g., insufficient sleep, obstructive sleep apnea, or other sleep disorders.Hypna go gic hallucinations occur while going to sleep. Other : : depression, obesity, impotence or low sex drive, headaches, decreased functional performance.Automatic behavior: During narcoleptic episodes, patients often perform routine repetitive tasks automatically without conscious awareness of their environment.Hypnopompic hallucinations: experienced while waking up (less common than hypnagogic hallucinations).Hypnagogic hallucinations: vivid, often frightening visual or auditory hallucinations that occur as the patient falls asleep.Sleep paralysis: Complete p aralysis occurs for 1–2 minutes after waking or before falling asleep (either during a nocturnal or narcoleptic sleep episode, i.e., begins or ends with REM sleep).Usually resolves within a few seconds, at most two minutes.Typically manifests as partial cataplexy: isolated weakness of distinct muscle groups (e.g., neck muscles weaken and head tilts forward).The loss of muscle tone is similar to that observed during REM sleep.Typically manifests months or even years after EDS.Cataplexy : sudden muscle weakness in a fully conscious person, triggered by strong emotions (e.g., laughing, crying).

One of the earliest manifestations of narcolepsy.

Excessive daytime sleepiness ( EDS ): Affected individuals experience an irresistible urge to sleep and s udden, short sleep attacks ( < 30 minutes ), which may occur in inappropriate situations (e.g., while driving a car).

In about 10 percent of cases, narcolepsy runs in families. Less often, the cause of narcolepsy is an injury that damages the brain. Their immune system mistakenly turns against their body and attacks the brain cells that produce hypocretin. Some people experience hallucinations and sleep paralysis when they’re falling asleep or waking up.Ĭertain people with autoimmune disorders are more likely to get narcolepsy with cataplexy. The lack of hypocretin makes it hard for someone to stay awake during the day, blurring the line between wakefulness and sleep. That loss of muscle tone causes you to lose control over your body when you’re awake. It’s the same loss of muscle tone that naturally happens during rapid eye movement (REM) sleep. The loss of muscle tone, cataplexy, happens because sleep and wakefulness overlap in narcolepsy. When it’s in short supply, your brain has trouble regulating your sleep-wake cycles. This chemical, which is produced in a brain region called the hypothalamus, controls sleep and wakefulness. Low levels of the chemical hypocretin cause narcolepsy with cataplexy. Narcolepsy affects signals in your brain that are supposed to keep you awake.