Narcolepsy: clinical differences and association with other sleep disorders in different age groups

Nevšímalová, Soňa; Piško, Juraj; Bušková, Jitka; Kemlink, David; Příhodová, Iva; Šonka, Karel; Skibová, J

doi:10.1007/s00415-012-6702-4

Cited by 50 publications

(42 citation statements)

References 42 publications

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“…Individuals with cataplexy display transient, typically bilateral muscle weakness, most often provoked by strong emotion, and with consciousness fully preserved. 1 The most common triggers of cataplexy are laughter (92 % of patients), anger (70 %), and startle reaction (55 %). 2 Muscular weakness that resolves immediately after an attack is a cardinal feature of cataplexy, and often affects the jaw or face rather than the lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Narcolepsy with Cataplexy in an Elderly Woman

et al. 2015

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A 72-year-old woman was referred for a 15-year history of brief attacks of generalized weakness that occurred when she was tense or startled. During these episodes, she squatted, closed her eyes, and had difficulty speaking, but there was no disturbance of consciousness. The cerebrospinal fluid level of orexin/hypocretin was low (92 ng/ L), leading to a diagnosis of narcolepsy with cataplexy according to the International Classification of Sleep Disorders (ICSD)-2 criteria. Cataplexy should be considered for sudden attacks of weakness lasting less than 2 minutes and with no alteration of consciousness. Measurement of cerebrospinal fluid levels of orexin/hypocretin is recommended when the diagnosis is uncertain. CASE REPORTA 72-year-old woman was referred to our hospital by her primary care doctor for a 15-year history of experiencing Battacks^during which she Blost body control.^These episodes occurred one to ten times on most days, and lasted approximately 1 minute. They occurred when she was tense or startled (e.g. telephone ringing, unexpectedly meeting an acquaintance, or being called into the clinic room by her doctor). During these episodes, she closed her eyes, squatted, and had difficulty speaking. While she could not answer questions, she maintained consciousness and was able to hear the individuals around her and could accurately recall their conversations.The patient reported that she often fell asleep during the day, including during meals, and that she frequently took 15-minute naps that refreshed her temporarily. She occasionally experienced hypnagogic hallucinations, but did not experience sleep paralysis. None of her relatives had similar symptoms. The patient had a 4-year history of well-controlled diabetes, as well as hypertension and hyperlipidemia; she had no complications from her diabetes. Medications included metformin, voglibose, glimepiride, losartan, hydrochlorothiazide, nifedipine, and atorvastatin.The patient had experienced attacks at her physicians' offices, and they had been witnessed by generalists, neurologists, and neurosurgeons, who had variously diagnosed essential tremor, orthostatic hypotension, epilepsy, and psychosomatic disease. A video of an attack was recorded when she visited our clinic (see video link), which showed her experiencing paroxysmal weakness. As can be seen in the video, when the patient was called into the clinic room, she first stood up from her chair and then assumed a half-sitting posture with her head and arms hanging down and her eyes closed. Although she was able to temporarily stand again and walk a few steps, she subsequently became unable to support herself and had to squat down. After 1 minute, she recovered and was able to stand and move normally.Physical exam results, including vital signs, cardiopulmonary, and neurological findings, were normal. Her body mass index was 32 (162 cm, 72 kg). Basic lab values were within normal limits, including hemoglobin A1 C , which was stable at 6.8 %.The patient underwent monitoring during these episodes. Bl...

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Section: Discussionmentioning

confidence: 99%

Narcolepsy with Cataplexy in an Elderly Woman

et al. 2015

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“…The clinical course of this chronic disease changes from childhood through to old age with only 50 % of paediatric cases having cataplexy compared to 80 % of adults. Older adults with narcolepsy are far more likely to have associated sleep disorders such as obstructive sleep apnoea (OSA), PLMS, RLS and disrupted night sleep [7]. These sleep disorders clearly worsen quality of life, have separate therapies and should be born in mind in a previously well-treated patient who complains of worsening symptoms.…”

Section: Hypersomniasmentioning

confidence: 98%

An update in sleep neurology: the latest bedtime stories

Anderson

2014

J Neurol

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In the 24/7 modern society, sleep disorders and the role of normal amounts and timing of sleep for health are often neglected by both doctors and their patients. Sleep has been said to be "of the brain, by the brain and for the brain" and the most immediate and obvious consequence of disrupted sleep is impaired brain function. This review will cover some of the recent papers published in both the Journal of Neurology and elsewhere in 2013/2014 that have advanced our knowledge of sleep and circadian rhythm disorders.

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“…The association of RBD with this disease is strongest in narcolepsy type 1 (narcolepsy with cataplexy) [5]. As discussed above, it represents unique phenotype, with equal gender distribution and less aggressive dream enactment movements [48].…”

Section: Other Neurological Disordersmentioning

confidence: 99%

“…This term denotes RBD in conjunction with a neurological disorder like an alpha-synuclein disorder [1,3], narcolepsy [1,4,5], or paraneoplastic disorders [6,7]. The expression secondary RBD is also used synonymously by other authors [1].…”

Section: Symptomatic Rapid Eye Movement Sleep Behavior Disordermentioning

confidence: 99%

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Rapid Eye Movement Sleep Behavior Disorder: Overview and Current Perspective

Irfan

Howell

2016

Curr Sleep Medicine Rep

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Rapid eye movement (REM) stage of sleep in normal circumstances is composed of vivid dream mentation associated with physiological skeletal muscle paralysis and thus, quiescence of motor activity. REM sleep behavior disorder (RBD) is a parasomnia characterized by disinhibition of motor control facilitating dream enactment behaviors. These nocturnal motoric behaviors due to lack of REM atonia range from benign limb movements to complex aggressive actions but are often manifested by violent, aggressive flailing, punching and kicking with vocalizations enacting action-filled hostile dreams. Polysomnographic evidence of increased electromyographic tone during REM with or without capturing clinical dream enactment together with careful history helps diagnose RBD. It is considered a prodromal feature of neurodegenerative alpha-synucleinopathies with high rate of eventual phenoconversion. The mainstay of treatment is to first ensure physical safety. When medications are necessary, options include either low-dose clonazepam, high-dose melatonin or both. Yearly surveillance with detailed neurological evaluation is vital for early detection and eventual management of neurodegenerative disorder.

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Narcolepsy: clinical differences and association with other sleep disorders in different age groups

Cited by 50 publications

References 42 publications

Narcolepsy with Cataplexy in an Elderly Woman

Narcolepsy with Cataplexy in an Elderly Woman

An update in sleep neurology: the latest bedtime stories

Rapid Eye Movement Sleep Behavior Disorder: Overview and Current Perspective

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