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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Sarah Hudson

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas.

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