Mathis J
Neurologische Universitätsklinik Bern.
Schweiz Med Wochenschr. 1992 Sep 19;122(38):1385-93.
Narcolepsy is a potentially invalidating disorder of the sleep and wakefulness structure, characterized by attacks of sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis and disturbed night sleep. The diagnosis is mainly based on the history. Additional sophisticated examinations, such as nocturnal polysomnography, are primarily indicated to rule out other causes of excessive daytime somnolence. The recently detected high correlation between a certain HLA status and cataplexy has led to new pathogenetic concepts. The primary aim of the therapy is to keep the patient at work rather than attempting a symptom free state. Measures to organize his day with planned naps should precede the use of medication. Besides stimulants against daytime somnolence and tricyclic antidepressants to suppress cataplectic attacks, some new drugs have been administered successfully against the various symptoms of narcolepsy in recent years.
发作性睡病是一种可能导致功能丧失的睡眠和觉醒结构障碍,其特征为嗜睡发作、猝倒、入睡前幻觉、睡眠麻痹以及夜间睡眠紊乱。诊断主要基于病史。额外的精密检查,如夜间多导睡眠图,主要用于排除白天过度嗜睡的其他原因。最近发现的特定人类白细胞抗原(HLA)状态与猝倒之间的高度相关性引发了新的发病机制概念。治疗的主要目标是使患者能够继续工作,而非试图达到无症状状态。在使用药物之前,应先采取措施通过有计划的小睡来安排患者的一天。除了使用对抗白天嗜睡的兴奋剂和抑制猝倒发作的三环类抗抑郁药外,近年来一些新药已成功用于治疗发作性睡病的各种症状。