Periodic somnolence hyperphagia

Introduction The main symptoms are periodic, episodic sleepiness and hypersexuality. When you have a sleepiness episode, you can sleep and wake up. You can blink, but you can't talk, you are indifferent to things around you, and you are easily provoked. During the period, there is often an appetite, which can wake up to eat, sleep after eating, and the amount of food is greatly increased, accompanied by a rapid increase in body weight (up to 1 to 2 kg per day), with or without psychiatric symptoms. The episode lasts for 1 day. After ~2 weeks of recovery, there was no abnormality during the interval. However, it can be repeated, ranging from 2 to 4 months. Some patients may have endocrine changes, or autonomic dysfunction.

Cause

(1) Causes of the disease

The cause is unclear, and it is generally considered that the interstitial brain lesions, especially the subthalamic lesions. Some people think that this is a kind of evil type of snoring, not an independent disease; some people think that this disease is related to infection, it is mild encephalitis; some people think that it is a kind of epilepsy according to the patient's EEG abnormality .

(two) pathogenesis

According to modern medical research on neurobiochemistry, pathology and physiology, it is believed that the drowsiness-Bulimia syndrome is mildly caused by the function of the limbic system-hypothalamus-brain backbone network structure infection, trauma and congenital defects. The underlying lesions caused the patient to develop the disease after puberty due to dysfunction of the internal environment and endocrine system.

an examination

Related inspection

Cerebrospinal fluid colloidal gold test cerebrospinal fluid tuberculous meningitis antibody cerebrospinal fluid magnesium cerebrospinal fluid meningococcal antigen brain CT examination

Physical examination showed no positive signs, EEG can be normal, but also can be expressed as moderate abnormalities, the basic rhythm is slowed to 8 to 9 times / s rhythm, double forehead high amplitude wave, single wave. There were no abnormalities in the CT, MRI scan and cerebrospinal fluid examination of the skull.

According to typical, periodic episodes of lethargy and appetite, it is not difficult to diagnose. It should be noted that in combination with narcolepsy, narcolepsy also has paroxysmal sleepiness, but there is no appetite. With symptoms such as tripping, sleep paralysis, and illusion of falling into sleep, MSLT showed pathological REM sleep.

Differential diagnosis

When patients have mild EEG abnormalities during the attack, they need to be differentiated from epilepsy, encephalitis, and brain tumors. In addition, it also needs to be differentiated from spontaneous hypoglycemia, hypothyroidism, narcolepsy, and periodic psychosis during the attack.

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