|
What is Narcolepsy - Symptoms
Narcolepsy is a disorder of sleep associated with excessive daytime sleepiness, involuntary daytime sleep episodes, disturbed nocturnal sleep, and cataplexy (sudden weakness or loss of muscle tone, often elicited by emotion). Narcolepsy affects over 100,000 people in the United States and appears to have a genetic basis. Offspring of narcoleptic patients commonly exhibit excessive daytime sleepiness and have at least a one hundredfold higher incidence of narcolepsy than the general population. Symptoms typically begin in the second decade, although the onset can range from 5 to 50 years of age. Often an identifiable stress (sleep cycle disruption, death in family, divorce) may precede symptom onset. Four classic elements can be seen in the narcoleptic patient:
1. Excessive daytime sleepiness: All patients with narcolepsy have some verifiable degree of excessive daytime sleepiness.
2. Cataplexy: Approximately 80% of narcoleptic patients will exhibit this symptom.
3. Hypnogogic hallucinations: This refers to the occurrence of vivid hallucinatory dream imagery at sleep onset. A much smaller percentage of narcoleptics will report this symptom.
4. Sleep paralysis: This refers to the awareness that the voluntary musculature is paralyzed coincident with the onset of sleep. Evaluation of suspected narcolepsy involves the use of a special sleep study known as the multiple sleep latency test (MSLT). This involves the repeated measurement of time to onset of sleep at two hour intervals under standardized conditions during a day following a nights sleep. Nocturnal sleep recording can also be performed looking for abnormal REM (sleep stage) sleep regulation.Treatment for narcolepsy is symptomatic. Daytime sleepiness can be treated with stimulants. Amphetamine use is limited due to side effects, tolerance, and drug dependence. Methylphenidate is considered the drug of choice by most, but pemoline (with less side effects) is also used. Treatment of cataplexy and hypnogogic hallucinations requires tricyclic antidepressants. Protriptyline is most commonly used tricyclic in the United States at this time.
Hope this article will provide you information about narcolepsy.
|
