Narcolepsy

Introduction Paroxysmal sleep is an irresistible sleep episode, and most of the causes are unknown. In addition to normal sleep, you can fall asleep at any time or place (such as walking, talking, eating, and labor). Each time lasts for a few minutes to several hours, it can be sent in a few days. Occurs in young men. In addition to normal sleep, you can fall asleep at any time or place (such as walking, talking, eating, and labor). Each time lasts for a few minutes to several hours, it can be sent in a few days.

Cause

(1) Causes of the disease

The etiology is unclear and may be related to a decrease in the function of the ascending activation system of the brainstem network or an increase in the reticular nucleus function of the caudal brain. There are also studies that consider autosomal dominant hereditary diseases, although there are high rates in certain ethnic groups, such as Japanese, but cases are reported in various ethnic groups and around the world. Its genetic characteristics are closely related to human HLA minimal tissue-related genes (DR and DQ sites) in various populations. The pathogenesis is a regulatory disorder of REM sleep, with loss of control of REM sleep immediately following the NREM sleep cycle. The tendency to enter REM sleep increases both at the beginning of sleep and during waking.

(II) Pathogenesis Sandyk (1995) believes that the dysfunction of the pineal gland and its secretion of melatonin may be related to the occurrence of this disease. Some people think that it may be related to brain trauma, viral infection, immune dysfunction, brain tumor, multiple sclerosis and other diseases. The occurrence of normal REM sleep depends on the triggering of the serotonin system of the brainstem nucleus to other transmitter systems, and this triggered rhythm disorder can occur in this disease.

Yoss reported in 1960 that there were 12 (7 males and 5 females) of the 3 generations of a family. Animal experiments have shown that when both parents of the dog are narcolepsy, all litter of puppies are affected, and these dogs are unaffected by puppies that are mated or bred by unrelated or distantly related dogs. The pattern of transmission may be autosomal recessive. But at the same time, it was found that not all types of dogs showed genetic transmission of narcolepsy, and there may be different causes.

Honda et al reported that 100% of narcolepsy patients in Japan showed positive human leukocyte antigen HLA-DR2. European and American scholars have also confirmed that most Caucasian narcolepsy patients are HLA-DR2, DQWl, DW2 positive. However, Guilleminault et al believe that the transmission of narcolepsy is multifactorial, and environmental factors also play an important role.

an examination

Related inspection

Neurological examination EEG examination

diagnosis

1. Good for young men.

2. In addition to normal sleep, you can fall asleep at any time or place (such as walking, talking, eating and labor), not homemade. Each time lasts for a few minutes to several hours, it can be sent in a few days.

3. often accompanied

1 squatting. Sudden limb weakness, unable to maintain normal posture and fall to the ground, clear consciousness, short duration, often occurs after laughter, fear or anxiety.

2 sleep snoring. When you fall asleep or just wake up, your limbs can't move, but blinking, breathing, and even talking as usual, it takes several minutes to several hours, you can feel a sense of death.

3 fall into the illusion of sleep. Before going to sleep, there may be visual and auditory hallucinations similar to dreams, accompanied by fear.

4. EEG examination can have sleep episodes and sleep EEG performance, REM (rapid eye movement) sleep can appear early.

5. Note the exclusion of Kleine-Levin syndrome, Pickwick-like fat child syndrome, thalamic and upper brain stem tumors or inflammation and epileptic seizures.

Differential diagnosis

Must be identified with the following diseases.

First, epileptic seizures. More common in children or adolescents, with disturbance of consciousness as the main symptom, often sudden loss of consciousness, eye-opening, standing still, not falling; or suddenly ending the ongoing action, such as holding the object, can not continue the original action, It lasts for a few seconds. The electroencephalogram can have a 3 Hz spine-slow integrated wave.

Second, fainted. A transient transient loss of consciousness due to cerebral blood circulation disorders. There are many short signs of dizziness, weakness, nausea, blackness in front of the eyes, and then fainted after loss of consciousness. Often accompanied by autonomic symptoms, such as pale, cold sweat, weak pulse, lower blood pressure, lasting for a few minutes.

Third, Kleine-Levin syndrome. Also known as periodic sleepiness and pathological hunger syndrome. Usually seen in male juveniles, with periodic episodes (intervals or weeks), each lasting 3 to 10 days, manifested as lethargy, bulimia and behavioral abnormalities. The etiology and pathogenesis are still unclear, and may be caused by dysfunction of the diencephalon, especially the hypothalamus or focal encephalitis.

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