Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
Part VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2shi KanbayashiIntroductionIn this chapter, the clinical and pathophysiological aspects of idiopathic and symptomatic narcolepsy cataplexy syndromes and hypersomnia (or excessive daytime sleepiness, EDS) are discussed. Although no systematic epidemiological study has been conducted, available data su Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ggest that hypersomnia (both idiopathic and symptomatic) is common but under-diagnosed; both types of hypersomnia significantly reduce the quality ofEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
life (QOL) of the subjects. Narcolepsy-cataplexy type 1. narcolepsy without cataplexy (a prototypical hypersomnia) type 2. and idiopathic hypersomnia Part VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2clinical overlap among these disorders lias been noted, as each disorder is currently diagnosed by mostly sleep phenotypes and not by biologically.pathophysiologically based tests, similarly, symptomatic hypersomnia IS a heterogeneous disease entity and the biological pathophysiological mechanisms u Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2nderlying symptomatic hypersomnia are mostly unknown.Recent progress for understanding the pathophysiology of EDS particularly owes to the discovery oEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
f narcolepsy genes (i.e.. hypocretin receptor and peptide genes) in animals in 1999 and the subsequent discovery in 2000. of hypocretin ligand deficiePart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2cted by cerebrospinal fluid (CSF) hypocretin-1 measures: low csr hypocrclin-l levels are seen in over 90% of narcolepsy-s. Nishiflo IÙL I ■ M. Sato - M. MatsumuraStanford university sleep and Circadian Neurobiology Laboratory.Department of Psychiatry and Behavioral Sciences, StanfordUniversity Schoo Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2l of Medicine. 3165 Porter Drive. RM1195. PaloAlto. CA 94304, USAe-mail: nishinogstanford.eduT. KanbayashiDepartment of Neuropsychiatry. Akita UniversEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
ity, Akita, Japans. Chftkroveny. M. Billiard (ed3.). sieep Medicine. DOI 10.1007/978-1-4939-2089-1_26.© Springer Science-Business Media, LLC 2015catapPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2CSF hypocretin-1 levels have been included in the third revision of the international classifications of sleep disorder as a positive diagnosis for narcolepsy-cataplexy [1].Narcolepsy-cataplexy is tightly associated with human leukocyte antigen (IILA) DQB 1*0602. Hypocretin deficiency in narcolepsy- Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2cataplexy is also tightly associated with HL A positivity, suggesting an involvement of immune-mediated mechanisms for the loss of hypocretin neurons.Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
However, the specificity of HLA positivity for narcolepsycataplexy is much lower than that of low CSF hypocretin-1 levels, as up to 30% of the generaPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2.005%. respectively, but the prevalence of symptomatic (secondary) hypersomnia may be much higher. For example, about several million subjects in the USA suffer from chronic brain injury, and 75% of those people have sleep problems, and about half of them claim sleepiness [2], Symptomatic narcolepsy Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2 has also been reported, but the prevalence of symptomatic narcolepsy is much smaller, and only about 120 cases have been reported m the literature inEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
the past 30 years [3], rhe meta-analysis of these symptomatic cases indicates lhal hypocrelin deficiency may also partially explain the neurobiologicPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2elin systems integrate and coordinate the multiple wake-promoting systems, such as monoamine and acetylcholine systems to keep subjects fully alert |4|. suggesting that understanding of the roles of hypocretin peptidergic systems in sleep regulation in normal and pathological conditions is important Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2, as alternations of these systems may also be responsible not only for narcolepsy but also for other less well-defined hypersomnias.205206s. NishinoEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
et al.Since a large majority of patients with EDS are currently treated with pharmacological agents, new knowledge about the neurobiology of EDS will Part VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2s.This chapter focuses on pathophysiological mechanisms and nosological aspects of idiopathic and symptomatic hypersomnia. For the treatments of these conditions, refer to more specific publications available [5-8].Symptoms of NarcolepsyExcessive Daytime SleepinessEDS and cataplexy are considered to Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2 be the two primary symptoms of narcolepsy, with EDS often being the most disabling symptom. The EDS most typically mimics the feeling tliat people exEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
perience when they are severely sleep-deprived but may also manifest Itself as a chronic tiredness or fatigue. Narcoleptic subjects generally experienPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ften relieved by short naps (15-30 min), but in most cases the refreshed sensation only lasts a short time after awaking The refreshing value of short naps is of considerable diagnostic value. Sleepiness also occurs in irresistible waves in these patients, a phenomenon best described as “sleep attac Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ks." Sleep attacks may occur in very unusual circumstances. such as in the middle of a meal, a conversation, or riding a bicycle. These attacks are ofEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
ten accompanied by microsleep episodes [9]. where the patient “blanks out.” The patient may then continue his or her activity in a semiconscious mannePart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2s and impaired concentration are frequently associated [9-13]. but psychophysiological testing is generally normal.Sleepiness is usually the first symptom to appear, followed by cataplexy, sleep paralysis, and hypnagogic hallucinations [14-IS], Cataplexy onset occurs within 5 years after the occurre Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2nce of daytime somnolence in approximately two-thirds of the cases (15, 17], Less frequently, cataplexy appears many years after the onset of sleepineEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
ss. The mean age of onset of sleep paralysis and hypnagogic hallucinations is also 2-7 years later than that of sleepiness [14. 19],In most cases. EDSPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2tivities), daytime napping, and adjustment of nighttime sleep.CataplexyCataplexy is distinct from EDS and pathognomonic of the disease [20]. The importance of cataplexy for the diagnosis of narcolepsy has been recognized since its description [21. 22] and in subsequent reviews on narcolepsy (23. 24] Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2, Most authors now recognize patients with recurring sleepiness and cataplectic attacks as a homogeneous clinical entity, and this is now shown to beEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
tightly associated with hypocretin deficiency (see the section on the pathophysiology of the disease). Cataplexy is defined as a sudden episode of musPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ll of the fishing rod with a biting fish, and the perfect hit at baseball), and less frequently by negative emotions (most typically anger or frustration). All antigravity muscles can be affected leading to a progressive collapse of the subject, but respiratory and eye muscles are not affected. The Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2patient is typically awake at the onset of the attack but may experience blurred vision or ptosis. The attack is almost always bilateral and usually lEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
asts a few seconds. Neurological examination performed at the time of an attack shows a suppression of the patellar reflex and sometimes presence of aPart VIINeurological Sleep DisordersNarcolepsy-Cataplexy Syndrome and Symptomatic Hypersomnia26Seiji Nishino, Masatoshi Sato, Mari Matsumura and Takas Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ropping, facial muscle flickering, sagging of the jaw. or w eakness in the arms. Slurred speech or mutism is also frequently associated. It is often imperceptible to the observer and may even be only a subjective feeling difficult to describe, such as a feeling of warmth or that somehow time is susp Ebook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2ended [24. 25]. In other cases, it escalates to actual episodes of muscle paralysis that may last up to a few minutes. Falls and injury are rare and mEbook Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment: Part 2
ost often the patient will have time to find support or will sit down while the attack IS occurring. Long episodes occasionally blend into sleep and mGọi ngay
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