The nature of sleep attack and other symptoms of narcolepsy

Hishikawa, Yasuo; Nan'no, Hisashige; Tachibana, Mitsuo; Furuya, Eisuke; Koida, Hidenori; Kaneko, Ziro

doi:10.1016/0013-4694(68)90060-6

Cited by 65 publications

(18 citation statements)

References 12 publications

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“…Twenty (9.0%) narcoleptic and 27 (79.4%) idiopathic eNS hypersomnic patients had no SOREMPs during Sleep, Vol. 9, No. 1,1986 Downloaded from https://academic.oup.com/sleep/article-abstract/9/1/232/2742950 by guest on 06 June 2019 MSLT.…”

Section: Multiple Sleep Latency Testmentioning

confidence: 99%

“…Nocturnal polysomnographic (NPSG) studies have described two important features of narcolepsy that are not present in idiopathic CNS hypersomnia: the sleep-onset REM period (SOREMP) and disrupted nocturnal sleep (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). SOREMPs occur both at night and during daytime naps, and their occurrence on two or more of five consecutive multiple sleep latency test (MSLT) naps is the major polysomnographic criterion used to distinguish narcolepsy from idiopathic CNS hypersomnia (14)(15)(16).…”

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confidence: 99%

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Comparative Polysomnographic Study of Narcolepsy and Idiopathic Central Nervous System Hypersomnia

Baker

Guilleminault

Niño-Murcia

et al. 1986

Sleep

113

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Summary: Patients with a primary diagnosis of narcolepsy or idiopathic CNS hypersomnia seen at Stanford University Sleep Disorders Clinic over a 5-year period were studied retrospectively. The two patient groups were compared with respect to blood pressure, Minnesota Multiphasic Personality Inventory (MMPI) psychological profile, nocturnal sleep structure, prevalence and severity of sleep apnea and periodic leg movements in sleep, and daytime sleep tendency. Narcoleptic patients tended to have higher blood pressure, higher prevalence of abnormally elevated MMPI scores, more abbreviated and more disrupted sleep at night, and greater daytime sleep tendency. Sleep apnea and periodic leg movements were more prevalent in narcoleptic patients, but only periodic leg movements in sleep were more prevalent in narcoleptic patients than in the general popUlation. Periodic leg movements during REM sleep were observed in more than one-third of narcoleptic patients, which may be an important pathophysiologic feature of this disorder. Key Words: Narcolepsy-Idiopathic central nervous system hypersomnia-Sleep stages-Multiple sleep latency test-Nocturnal myoclonus-Sleep apnea-Minnesota Multiphasic Personality Inventory-Nocturnal polysomnogram.Narcolepsy and idiopathic central nervous system (CNS) hypersomnia are both disorders characterized by symptoms of excessive daytime sleepiness (EDS) not directly attributable to medical, toxic, or psychiatric factors. These two disorders have many similarities, including age of symptom onset, nonremission of symptoms over the life span, and heredofamilial tendency. The symptoms that differentiate narcolepsy from idiopathic CNS hypersomnia are cataplexy, hypnagogic hallucinations, and sleep paralysis (1).Bedrich Roth was the first to clearly isolate the idiopathic hypersomnia syndrome, differentiating it from narcolepsy on the basis of comprehensive symptom histories of over 600 cases of hypersomnia (2,3). Both nighttime sleep and daytime naps of idiopathic hypersomnic patients are prolonged and rarely interrupted by awakenings. In contrast, the nocturnal sleep of narcoleptic patients is of normal duration, and in some patients, sleep

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Section: Multiple Sleep Latency Testmentioning

confidence: 99%

mentioning

confidence: 99%

Comparative Polysomnographic Study of Narcolepsy and Idiopathic Central Nervous System Hypersomnia

Baker

Guilleminault

Niño-Murcia

et al. 1986

Sleep

113

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“…Cohn and Cruvant (2), Roth (3), Stoupel (4), Vizioli and Giancotti (5), Bjerk and Hornisher (6) and Lugaresi (7) have described abnormalities in the EEGs of narcoleptic patients, indicating that the disease might be an "epileptic equivalent," while the majority of the investigators, including Blake et al (8), Dynes and Finley (9), Gibbs and Gibbs (10,11), Aird et al (12), Heyck and Hess (13), Daly and Yoss (14), Gastaut and Roth (15) and Roth (16), have reported electroencephalograms within normal limits. There is also evidence of a disturbed all-night sleep process in narcolepsy, i.e., narcoleptic patients have an insufficient n umber of deep slow waves sleep stages, numerous episodes of waking, and sometimes an excess of REM sleep (5,17,18), Rechtschaffen et al (18), Roth et al (19), Vincent et al (20) and Hishikawa et al (21) also reported a characteristic onset of sleep with REM activity when cataplexy was present. Thus, till now the main goals in the treatment of such cases have been improvement of the disturbance in the sleep-awake cycle, maintenance of wakefulness during daytime, insurance of sound sleep at night, and relief from cataplectic attacks which 154 are often triggered by emotionally upsetting situations, such as laughter, angel' and fright.…”

Section: Inthoductionmentioning

confidence: 96%

Prediction of Drug Treatment Effective in Narcolepsy Based on Digital Computer Analyzed EEG

Saletu¹,

M.²,

Keskiner³

1971

Clinical Electroencephalography

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“…konnten 1966 zeigen, daß Zeichen paradoxen Schlafes kurz nach Schlafbeginn bei Narkoleptikern auch während des Tages auftreten. An der weiteren Erforschung der Narkolepsie mit der polygrafischen EEG-Ableitung haben sich zahlreiche Wissenschaftler beteiligt (Hishikawa et al 1968, Passouant et al 1968, Roth et al 1968 (Passouant 1967): Im Wachzustand steht der zerebrale Kortex ständig unter dem Einfluß des aufsteigenden retikulären Aktivierungssystems. Der langsame Schlaf entspricht einer Verminderung des aufsteigenden retikulären aktivierenden Tonus.…”

Section: Zusatzuntersuchungenunclassified

Die Narkolepsie (Morbus Gélineau)

Hagel¹

1980

Fortschr Neurol Psychiatr

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ZusammenfassungIn der vorliegenden Arbeit wird an Hand der Literatur ein Überblick über die Narkolepsie und den derzeitigen Stand der Forschung gegeben. Die typische klinische Symptomatologie in Form der narkoleptischen Attacke, Kataplexie, Schlaflähmung und hypnagogen Halluzinationen ist seit langem bekannt. Etwa die Hälfte aller Narkolepsie-Patienten leiden zusätzlich an Durchschlafstörungen. Aetiologisch liegt der narkoleptischen Symptomatik eine noch unklare Affektion im mesodienzephalen Bereich zugrunde, vermutlich im Sinne einer neurohumoralen Insuffizienz, die entweder ohne erkennbare äußere Ursache (primäre Form)im 2. Lebensjahrzehnt oder als Folge einer organischen Hirnschädigung (sekundäre Form) auftritt.Pathogenetisch kann das narkoleptische Syndrom als Störung des physiologischen Schlafmechanismus mit unzureichender, beziehungsweise in kompletter Hemmung zentraler Funktionskreise verstanden werden. Durch polygrafische EEG-Untersuchungen konnten 3 Formen der Narkolepsie herausgearbeitet werden, nämlich eine isolierte Störung des normalen Schlafes (Typ NREM), eine überwiegende Störung des normalen Schlafes mit geringer Beeinträchtigung des paradoxen Schlafes (Typ NREM-REM) und eine überwie-gende Störung des paradoxen Schlafes mit geringer Beeinträchtigung des normalen Schlafes (Typ REM-NREM).Die zugrundeliegenden biochemischen Veränderungen sind weiterhin weitgehend unbekannt.In therapeutischer Hinsicht wird auf die große Bedeutung soziotherapeutischer Maßnahmen und eine gesunde Lebensftihrung hingewiesen. Die medikamentöse Therapie wird heute allgemein mit Imipraminen und/ oder Weckaminen (besonders Ritalin) durchgeführt. Historischer RückblickDie erste uns bekannte Beschreibung der Narkolepsie findet sich bei Thomas Willis 1685. Er schildert Patienten, die bei allen Verrichtungen des täglichen Lebens plötzlich vom Schlaf über-wältigt werden. Therapeutisch verordnete er seinen Patienten unter anderem bereits Kaffee.1836 berichtet Bright über die Obduktion eines Narkolepsie-Kataplexie-Patienten, 1851 folgt Nareolepsy (Morbus celineau)In this treatise a survey of narcolepsy and the present state of research in this field is shown by means of the literature. The typical clinical symptoms as narcoleptic attacks, cataplexy, sleep paralysis and hypnagogic hallucinations have long been known. Nearly half of the narcoleptic patients suffer from sleep disorders as weil.As far as aetiology is concerned the cause of this narcoleptic symptoms is astilI unknown affeetion in the mesodieneephalie area presumably in the sense of a neurohumoral insufficiency that oceurs in the seeond decade of the life without (idiopathic form) or following an organie dammage of the brain (symptomatic form).Pathogenetieally the narcoleptic syndrome can be seen as a disturbance of the physiologic sleep mechanism eonsisting of a insuffieient respectively ineomplete inhibition of central functions.

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The nature of sleep attack and other symptoms of narcolepsy

Cited by 65 publications

References 12 publications

Comparative Polysomnographic Study of Narcolepsy and Idiopathic Central Nervous System Hypersomnia

Comparative Polysomnographic Study of Narcolepsy and Idiopathic Central Nervous System Hypersomnia

Prediction of Drug Treatment Effective in Narcolepsy Based on Digital Computer Analyzed EEG

Die Narkolepsie (Morbus Gélineau)

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