Tachibana Naoko, Taniike Masako, Okinaga Takeshi, Ripley Beth, Mignot Emmanuel, Nishino Seiji
Osaka Medical Center for Health Sciences and Promotion, Japan.
Sleep Med. 2005 Nov;6(6):567-9. doi: 10.1016/j.sleep.2005.04.002. Epub 2005 Aug 5.
Here we report a hypersomnolent girl with extensive hypothalamic damage after removal of a craniopharyngioma. The presence of a short sleep latency, sleep onset REM periods during a multiple sleep latency test (MSLT) and negative HLA DQB1*0602 typing suggested a diagnosis of symptomatic narcolepsy. Low cerebrospinal fluid hypocretin-1 level indicated destruction of hypocretin-producing neurons in the hypothalamus. An increased amount of REM sleep and a lack of REM sleep cyclicity documented by all-night polysomnography were different findings from previous reports of hypocretin-deficient idiopathic symptomatic narcolepsy. A more global hypothalamic lesion demonstrated by brain magnetic resonance imaging (MRI) after surgery seemed to cause marked disinhibition of REM sleep as well as hypersomnolence in this patient.
在此，我们报告一名患有颅咽管瘤切除术后广泛下丘脑损伤的嗜睡女孩。多次睡眠潜伏期试验（MSLT）中睡眠潜伏期短、睡眠起始快速眼动期以及HLA DQB1*0602分型阴性提示症状性发作性睡病的诊断。脑脊液中下丘脑分泌素-1水平低表明下丘脑产生下丘脑分泌素的神经元遭到破坏。全夜多导睡眠图记录的快速眼动睡眠量增加以及缺乏快速眼动睡眠周期性是与先前下丘脑分泌素缺乏的特发性症状性发作性睡病报告不同的发现。术后脑部磁共振成像（MRI）显示的更广泛的下丘脑病变似乎导致该患者快速眼动睡眠明显不受抑制以及嗜睡。
