NEJM-Narcolepsy Flashcards
Usually begins with what ages
10-20
OSA vs Nacrolepsy
OSA not refreshed after full nights sleep
Narcoleptic refreshed but has to sleep 1-2 hours later
Characteristic of REM sleep in narcolepsy
REM intrudes into wakeful states resulting in cataplexy which is a process that progresses over seconds and includes weakness in the face/neck then into the trunk and limbs.
What is partial cataplexy ?
slurred speech and sagging face resulting in slumping and possibly immobility but fully conscious state for 1-2 minutes
What type of hallucinations are rare in narcolepsy as opposed to psychotic disorders ?
Auditory
What % of the population is estimated to experience hypnagogic hallucinations ?
20%
What other symptoms often accompanies narcolepsy ?
weight gain, 15% above average BMI in adults
other sleep disorders that are more prevalent in the context of narcolepsy
PLMD,sleepwaling, REM sleep behavior disorder, OSA, depression
Distinguishing characteristics of delayed sleep phase disorder
alert at night and sleepy in the morning
Diagnosis of narcolepsy
Clinical but can be confirmed with a multiple sleep latency test preceded by a sleep study.
Before confirming narcolepsy what must be done ?
REM suppressing medications must be d/ced for up to 3 week and must get 6 hours during the sleep test
CSF finding in type 1 narcolepsy
low orexin A
98% of patients with narcolepsy have the HLA ______ ?
HLA-DQB1*06:02 (strongest association known currently)
Inheritance of narcolepsy
sporadic, monozygotic twin has 30% chance only
After the onset of narcolepsy what Ab has been shown to correlate ?
ASO, vaccines (pandemrix used in scandinavia) and flu viruses have been temporally linked
