Clinical features of childhood narcolepsy. Can cataplexy be foretold?

Nevšímalová, Soňa; Jara, Cecilia; Příhodová, Iva; Kemlink, David; Šonka, Karel; Skibová, J

doi:10.1016/j.ejpn.2011.01.008

Cited by 31 publications

(25 citation statements)

References 31 publications

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“…The symptoms were relatively severe (Table 1) but similar to those described in Caucasian children in other recent publications [34], [40], [41] and in the 1998–1999 series of 29 children from North China [42]. Psychiatric symptoms were common in our patients (48%) as it was in other studies as well (Table 1) [3], [40], [41], [42], [43].…”

Section: Discussionsupporting

confidence: 90%

Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland

et al. 2012

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BackgroundNarcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002–2010.MethodsAll Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference.FindingsAltogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002–2009 giving an annual incidence of 0.79 per 100 000 inhabitants (95% confidence interval 0.62–0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12–0.51) per 100 000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100 000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100 000, which equals that in 2002–2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy.InterpretationA sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children.

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Section: Discussionsupporting

confidence: 90%

Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland

et al. 2012

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“…This difference could be due to our study schedule with only 20% NwC in our population. In our study, NwC were more frequently of African origins . Except one, all the infants who received prior H1N1 vaccination and all the children with autoimmune diseases had cataplexy attacks in favor of an autoimmune origin of NC .…”

Section: Discussionmentioning

confidence: 47%

Impact of Obesity in Children with Narcolepsy

et al. 2013

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“…Clinical series suggest that patients with narcolepsy, with or without cataplexy, sometimes endorse sleep drunkenness (see Table 6). In children with narcolepsy, sleep inertia is reported to occur commonly [71], regardless of the presence of cataplexy [72]. On forced awakening from a three minute sleep episode, hypersomnolent patients frequently show high amplitude, frontal negative visual EP responses or a delayed visual P300 response [73].…”

Section: Sleep Inertia/sleep Drunkenness In People With Sleep Disordersmentioning

confidence: 99%

Waking up is the hardest thing I do all day: Sleep inertia and sleep drunkenness

Trotti

2017

Sleep Medicine Reviews

153

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Summary The transition from sleep to wake is marked by sleep inertia, a distinct state that is measurably different from wakefulness and manifests as performance impairments and sleepiness. Although the precise substrate of sleep inertia is unknown, electroencephalographic, evoked potential, and neuroimaging studies suggest the persistence of some features of sleep beyond the point of awakening. Forced desynchrony studies have demonstrated that sleep inertia impacts cognition differently than do homeostatic and circadian drives and that sleep inertia is most intense during awakenings from the biological night. Recovery sleep after sleep deprivation also amplifies sleep inertia, although the effects of deep sleep vary based on task and timing. In patients with hypersomnolence disorders, especially but not exclusively idiopathic hypersomnia, a more pronounced period of confusion and sleepiness upon awakening, known as “sleep drunkenness”, is common and problematic. Optimal treatment of sleep drunkenness is unknown, although several medications have been used with benefit in small case series. Difficulty with awakening is also commonly endorsed by individuals with mood disorders, disproportionately to the general population. This may represent an important treatment target, but evidence-based treatment guidance is not yet available.

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Clinical features of childhood narcolepsy. Can cataplexy be foretold?

Cited by 31 publications

References 31 publications

Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland

Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland

Impact of Obesity in Children with Narcolepsy

Waking up is the hardest thing I do all day: Sleep inertia and sleep drunkenness

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