1. Clinical characteristics of symptomatic narcolepsy or hypersomnia: an analysis of 182 consecutive cases with neurological disorders associated with hypersomnolence
- Author
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Aya Imanishi, Masahiro Takeshima, Takashi Kanbayashi, Y. Sagawa, K Tsutsui, Seiji Nishino, Tadayuki Ayabe, Tetsuo Shimizu, H. Ono, and Y. Ohmori
- Subjects
medicine.medical_specialty ,Sleep disorder ,Pediatrics ,Neurology ,Cataplexy ,Physiology ,business.industry ,Excessive daytime sleepiness ,Disease ,medicine.disease ,Orexin ,03 medical and health sciences ,0302 clinical medicine ,Neuropsychology and Physiological Psychology ,nervous system ,Physiology (medical) ,mental disorders ,medicine ,medicine.symptom ,business ,Pathological ,psychological phenomena and processes ,030217 neurology & neurosurgery ,Narcolepsy - Abstract
Symptomatic narcolepsy is characterized as low orexin (hypocretin) levels (≤ 110 pg/ml) due to neurological diseases. However, we have experienced the cases that show symptoms similar to narcolepsy, complaining of pathological sleepiness even in cases with intermediate orexin levels (110–200 pg/ml). Therefore, we reevaluated the previously reported cases to make the concept of disease to the group in which the orexin concentration is intermediate. Although orexin-deficient symptomatic narcolepsy has been reported worldwide, facilities that are capable of measuring orexin are still limited. Currently, our laboratory handles with almost all the CSF samples from Asian countries for determining orexin levels. We measured over 2500 cases including 182 cases suspected of symptomatic narcolepsy/hypersomnolence. Therefore, we subdivided these cases into three groups according to CSF orexin levels, low orexin group (≤ 110 pg/ml), intermediate orexin group (110–200 pg/ml), and normal orexin group (> 200 pg/ml). We defined “symptomatic hypersomnia” for hypersomnolence cases with intermediate CSF orexin levels. MSLT was recommended but not necessary. Short sleep latency (
- Published
- 2018