| Abstract | BACKGROUND AND OBJECTIVE: To evaluate the distribution of clinical, electrophysiological and biological variables, and their relationship with the CSF hypocretin-1 levels, in patients with central hypersomnias diagnosed as narcolepsy-cataplexy (NC), narcolepsy without cataplexy (NnC) and idiopathic hypersomnia (IH) based on the ICSD-2 criteria. PATIENTS AND METHOD: We performed in all patients a clinical interview, a nocturnal polysomnogram and a multiple sleep latency test (MSLT), HLA analysis and measurement of CSF Hcrt-1 levels (low < or = 110 pg/mL). RESULTS: Out of 51 patients, 31 were classified as NC, 11 as NnC and 8 as IH. 34 patients (66.7%) had low CSF Hcrt-1 levels (29 NC, 3 NnC and 1 IH). In the NC group, 96.1% were HLA DQB1*0602 positive and 91% had low CSF Hcrt-1 levels. The most frequent variables found in NC patients and in those with a low CSF Hcrt-1 levels were cataplexy, fragmented nocturnal sleep, short refreshing naps, automatic behavior, HLA DQB1*0602, and, in the MSLT, a short mean sleep latency, a higher number of REM sleep episodes and a short mean latency of REM sleep episodes. A long nocturnal sleep time and morning sleep drunkenness, 2 variables used in the ICSD-2 for the diagnosis of IH, were not different among the three groups of hypersomnias. CONCLUSIONS: Central hypersomnias have a superposition of several clinical, electrophysiological and biological variables that makes sometimes difficult the differential diagnosis. The measurement of CSF Hcrt-1 levels may help in the diagnosis of those patients with unclear clinical or electrophysiological forms. |
| Authors | José E Martínez-Rodríguez, Alex Iranzo, Roser Casamitjana, Francesc Graus, Joan Santamaria
(Affiliation: Servicio de Neurología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, España.)
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| Journal | Medicina clínica
(Med Clin (Barc))
Vol. 128
Issue 10
Pg. 361-4
(Mar 17 2007)
ISSN: 0025-7753 Spain |
| Vernacular Title | Análisis comparativo de un grupo de pacientes con narcolepsia-cataplejía, narcolepsia sin cataplejía e hipersomnia idiopática. |
| PMID | 17386240
(Publication Type: Comparative Study, English Abstract, Journal Article)
|
| Chemical References |
- HLA-DQ Antigens
- HLA-DQB1
- Intracellular Signaling Peptides and Proteins
- Neuropeptides
- orexins
|
| Topics |
- Adolescent
- Adult
- Aged
- Alleles
- Cataplexy
(cerebrospinal fluid, complications, physiopathology)
- Diagnosis, Differential
- Female
- Genetic Predisposition to Disease
- HLA-DQ Antigens
(genetics)
- Humans
- Hypersomnolence, Idiopathic
(cerebrospinal fluid, physiopathology)
- Intracellular Signaling Peptides and Proteins
(cerebrospinal fluid)
- Male
- Middle Aged
- Narcolepsy
(cerebrospinal fluid, complications, physiopathology)
- Neuropeptides
(cerebrospinal fluid)
- Polysomnography
- Sleep Disorders
(classification)
- Sleep, REM
|
