Shin Y K, Yoon I Y, Han E K, No Y M, Hong M C, Yun Y D, Jung B K, Chung S H, Choi J B, Cyn J G, Lee Y J, Hong S C
Department of Psychiatry, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
Acta Neurol Scand. 2008 Apr;117(4):273-8. doi: 10.1111/j.1600-0404.2007.00930.x. Epub 2007 Oct 8.
Narcolepsy typically begins between adolescence and early adulthood causing severe neuropsychiatric impairments, but few prevalence studies are available on adolescent narcoleptics. In the present study, we investigated the prevalence of narcolepsy-cataplexy in adolescents.
In total 20,407 students, aged 14-19 years, participated in this study. Ullanlinna Narcolepsy Scale (UNS) was applied to all subjects and those with a UNS score of > or =14 were contacted by phone for semi-structured interview. Subjects then suspected of having narcolepsy participated in a laboratory investigation, which included polysomnography and HLA typing, or were interviewed in detail by telephone.
Three subjects were finally diagnosed as narcolepsy with cataplexy and seven subjects might be diagnosed as narcolepsy without cataplexy. Among three narcoleptics with cataplexy, two subjects were HLA-DQB10602 and DRB11501 positive, but one subject had no test of HLA typing. The prevalence of narcolepsy with cataplexy in Korean adolescence was thus determined to be 0.015% (95% confidence interval = 0.0-0.0313%).
This epidemiologic study is the first of its type on adolescent narcolepsy to use the International Classification of Sleep Disorders, 2nd edition (ICSD-2) diagnostic criteria. Considering those cases with an onset after adolescence were not included, the prevalence of narcolepsy with cataplexy determined in the present study is comparable with that of other studies in adults.
发作性睡病通常在青春期至成年早期发病,会导致严重的神经精神障碍,但针对青少年发作性睡病患者的患病率研究较少。在本研究中,我们调查了青少年发作性睡病伴猝倒的患病率。
共有20407名年龄在14至19岁之间的学生参与了本研究。对所有受试者应用乌兰卡宁娜发作性睡病量表(UNS),UNS得分≥14分的受试者会接到电话进行半结构化访谈。随后怀疑患有发作性睡病的受试者参加了实验室检查,包括多导睡眠图和HLA分型,或通过电话接受详细访谈。
最终3名受试者被诊断为发作性睡病伴猝倒,7名受试者可能被诊断为无猝倒的发作性睡病。在3名发作性睡病伴猝倒的患者中,2名受试者HLA - DQB10602和DRB11501呈阳性,但1名受试者未进行HLA分型检测。因此,韩国青少年发作性睡病伴猝倒的患病率确定为0.015%(95%置信区间 = 0.0 - 0.0313%)。
这项流行病学研究是首次按照《国际睡眠障碍分类》第2版(ICSD - 2)诊断标准对青少年发作性睡病进行的此类研究。考虑到未纳入青春期后发病的病例,本研究确定的发作性睡病伴猝倒的患病率与其他针对成年人的研究结果相当。