4.28.2010

narcolepsy outline

Outline for Narcolepsy

Discovery

• First discovery of Narcoleptic like symptoms was founded by two German doctors in the 1870’s.

• 1877 – by Westphal

• 1878 – by Fisher

• They described their patients falling asleep randomly throughout the day under certain circumstances.

• Patients described having dream like hallucinations while awake.

• They also described having automatic behavior.

• 1880 – French doctor Gélineau recognized Narcolepsy as a disorder.

• He combined two Greek words, Narke (numbness) and Lepsis (attack) and got narcolepsie.

• He described the disorder as a sleep attack that followed intense motion.

• 1902 – Loëwenfeld separated the sleep attacks and muscle weaknesses.

• He named the muscle weaknesses cataplexy.

Narcolepsy – what is it?

• It is a frequent and lifelong disorder.

• A narcoleptic person usually has

o Periods of daytime sleepiness

o Cataplexy

o and sometimes hallucinations

• It is a neurological chronic disorder.

• It affects the part of the brain that regulates when to be awake and when to be asleep.

• It affects 50,000 people out of 2.4 million in the United states/1 out of every 2,000 people.

• Most people who are narcoleptic experience symptoms between the ages of 10 and 25.

Symptoms

• Usually begin in the teenage years and the disorder progresses and gets worse with age if not treated properly.

• Excessive daytime sleepiness.

• Abnormal REM sleep & rapid entry into REM (narcoleptic people usually hit the REM sleep within 15 minutes unlike a normal 90 minutes)

• Sleep paralysis – unable to move for a few minutes.

• Cataplexy – weaknesses of muscle – triggered by emotion.

• Hypnagogic hallucinations – dream like visual and auditory hallucinations.

• Micro sleep – brief periods of sleep when a person falls asleep but continues with regular (automatic behavior) activity. They awaken with no memories of it.

Diagnosis

• It’s usually easy to diagnosis a person narcoleptic because the symptoms are almost always present.

• Multiple sleep latency tests are suggested like…

o Epworth Sleepiness Scale

o Nocturnal polysommogram

o MSLT

o Spinal fluid analysis.

• The tests are administered at a sleep disorder clinic and they test for…

o Daytime sleepiness

o Night time insomnia

o Short latency prior to the first REM period test

Treatments

• Narcolepsy has no cure.

• It is a lifelong illness/disorder.

• Counseling or support groups are effective – narcoleptic episodes can cause one to be

o Depressed

o Withdrawn

o Reclusive

• Talking with others about your disorder and help you cope with the disorder.

• Medications also help…

o Antidepressants – keep your thoughts about the illness away

o Stimulants – keep you awake

o Sodium oxybate – central nervous system drug used to treat cataplexy

• Changing your behavior along with medications or other help can help you control narcolepsy.

Self help

• Schedule 10-15 minute sleep periods and have a good night’s sleep

• Avoid nicotine, caffeine, alcohol.

• Don’t focus on larger tasks, but break them down.

• Exercise daily

• Avoid dangerous activities.

• Wear a medical necklace or bracelet.

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