Narcolepsia

Abstract

ResumoContexto: Narcolepsia é uma síndrome neurológica crônica com prevalência entre 0,018% e 0,040% da população, sem diferenciações étnicas importantes. Caracteriza-se por sonolência e cataplexia. A fisiopatologia da doença não é totalmente conhecida, embora possua marcador genético (alelo HLA DQB1 *0602) e anormalidades na neurotransmissão de hipocretina descritos recentemente. Objetivos: Resumir as recentes descobertas na narcolepsia e expor possibilidades diagnósticas e terapêuticas. Metodologia: Revisão bibliográfica. Resultados e discussão: O diagnóstico deve seguir os critérios da Classificação Internacional de Sono. A dosagem de hipocretina é o melhor exame para confirmar narcolepsia em pacientes com cataplexia típica. O tratamento deve ser realizado com medidas comportamentais e drogas sintomáticas que promovem a vigília e controlam a cataplexia. Diagnósticos diferenciais como esquizofrenia, epilepsia, depressão e doenças do sono devem ser descartados. , F.M.S. et al. / Rev. Psiq. Clín. 34 (3); 133-138, 2007 Palavras-chave: Narcolepsia, genética, imunologia, diagnóstico e tratamento. Coelho AbstractBackground: Narcolepsy is a chronic neurological syndrome with prevalence between 0.018% and 0.040% without important ethnic differences. Narcolepsy is characterized by excessive daytime sleepiness and cataplexy. The pathophysiology of the illness is not known; even so it possesses genetic marker (allele HLA DQB1 *0602) and with abnormalities in the neurotransmission of hypocretin has been described in patients with narcolepsy. Objectives: Resume news discoveries in narcolepsy and show diagnoses and treatment options. Methods: Bibliographic review. Results and discussion: The diagnoses of narcolepsy must be done with The International Classification of Sleep Disorders criteria. The hypocretin dosage is the best exam to confirm diagnose in narcoleptic patients with typical cataplexy. The treatment is carried through with behavior actions and symptomatic drugs that promote the vigil and control the cataplexy. Differential diagnoses as schizophrenia, epilepsy, depression and others sleep disorders need to be eliminated.

Prevalence of the HLA-DQB1*0602 allele in narcolepsy and idiopathic hypersomnia patients seen at a sleep disorders outpatient unit in São Paulo

“…Some patients taking antidepressives drugs, dopamine agonists, and other drugs can simulate characteristics of narcolepsy. Clinical and electrophysiological differentiation could be difficult in these situations [13][14][15] . The gold standard exam for narcolepsy with cataplexy is Hypocretin-1 dosage, but in patients without cataplexy and in IH, diagnosis is not yet automatic.…”

Vozes do além: uma análise psicopatológica da eclosão de experiências anômalas em médiuns espíritas

“…Fund., São Paulo, 25( 1), 20-42, mar. 2022 médica, entre a transição sono-vigília e a produção de alucinações, sendo elas, nesses casos, não necessariamente patológicas (Aranha, 2004;Coelho et al, 2007;Serbena & Ilkiu, 2016). Em relação à experiência de paralisia motora relatada por um dos participantes, é importante ressaltar que se assemelha à condição conhecida como paralisia do sono.…”

The human leucocyte antigen DQB1*0602 allele is associated with electroencephelograph differences in individuals with obstructive sleep apnoea syndrome

“…Narcolepsy, a condition present in approximately 0.018–0.040% of the population, is characterized by excessive daytime sleepiness. It may be accompanied by rapid eye movement (REM) sleep intrusions into wakefulness, such as cataplexy, sleep paralysis and hypnagogic hallucinations (Coelho et al ., ). Several studies have demonstrated that variants in the major histocompatibility complex class II DQ beta 1 gene ( HLA‐DQB1 ) are associated strongly with increased risk of developing narcolepsy.…”

“…Several studies have demonstrated that variants in the major histocompatibility complex class II DQ beta 1 gene ( HLA‐DQB1 ) are associated strongly with increased risk of developing narcolepsy. Up to 95% of Caucasians with narcolepsy and cataplexy and approximately 40–50% of patients without cataplexy carry the HLA‐DQB1 *0602 allele (Coelho et al ., , ). Nevertheless, the HLA‐DQB1 *0602 allele is also present in asymptomatic, healthy individuals with a prevalence of 25% in Caucasian, 12% in Japanese populations and 38% in African American populations (Coelho et al ., ; Guilleminault and Fromherz, ).…”