11/13/2022 0 Comments Cataplexy in narcolepsy![]() The discovery of a significant decrease of the neurotransmitter hypocretin-1 levels in cerebrospinal fluid in patients with narcolepsy-cataplexy provided a new test to diagnose the condition.The observation that narcolepsy was associated with human leukocyte antigens (HLA)-DR2 was the first indication of a biologically based source.Pediatric narcolepsy has clinical features that may differ from those in the adult, masquerading as behavioral alterations or attention-deficit/hyperactivity disorder.Some patients with otherwise typical features of narcolepsy do not have cataplexy this is a condition referred to as narcolepsy type 2, also known as narcolepsy without cataplexy and in the past monosymptomatic narcolepsy.The classic form of narcolepsy (narcolepsy type 1) features cataplexy, sleep paralysis, and hypnagogic hallucinations, in addition to excessive daytime sleepiness.Narcolepsy is characterized by excessive daytime sleepiness.In the United States, the annual direct medical costs are 2-fold higher in patients with narcolepsy than in matched controls without narcolepsy ($11,702 vs. Pharmacologic treatment remains symptomatic but increasingly effective. Most cases of narcolepsy with cataplexy are associated with the loss of approximately 50,000 to 100,000 hypothalamic neurons containing hypocretin. New knowledge of the etiology and mechanism of the disease involving the hypocretins has opened a major pathway to understanding excessive sleepiness not only in narcolepsy but also in other sleep disorders. In this article, the author reviews the current information on narcolepsy, a disease that has progressed in only 50 years from a quasi-psychiatric condition to a true neurologic disorder. ![]()
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