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Narcolepsy

Narcolepsy is excessive daytime sleepiness, possibly accompanied by features such as: 
  • Cataplexy (=brief attacks of sudden loss of skeletal muscle tone and power, often in response to emotion)
  • Irresistible sleep attacks
  • Hyponagogic hallucinations 
  • Sleep paralysis 

It is believed that narcolepsy with cataplexy is due to loss of hypocretin-containing neurons in the hypothalamus. 

Onset usually in teens/20s 
Male predominance 
Increased risk if a family member has the disorder 

Associations with 
  • HLA DQB1 
  • Streptococcal infection
  • Heavy metal exposure 
  • H1N1 vaccination or infection

Management 
  • Narcolepsy
    • DVLA must be informed – usually able to continue driving cars (if controlled) but not bus/lorry 
    • Good sleep hygiene 
    • Medication 
      • Amphetamine-like stimulants such as dexamphetamine
      • Modafinil 
      • Sodium oxybate 
  • Cataplexy 
    • Antidepressant drugs such as clomipramine or SSRIs 



References 
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Abdelghafour

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)