高频重复经颅磁刺激有效治疗发作性睡病样症状：一例报告
Effective treatment of narcolepsy-like symptoms with high-frequency repetitive transcranial magnetic stimulation: A case report.
作者信息
Lai Jian-Bo, Han Mao-Mao, Xu Yi, Hu Shao-Hua
机构信息
aDepartment of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine bThe Key Laboratory of Mental Disorder's Management in Zhejiang Province cDepartment of VIP, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
出版信息
Medicine (Baltimore). 2017 Nov;96(46):e8645. doi: 10.1097/MD.0000000000008645.
RATIONALE
Narcolepsy is a rare sleep disorder with disrupted sleep-architecture. Clinical management of narcolepsy lies dominantly on symptom-driven pharmacotherapy. The treatment role of repetitive transcranial magnetic stimulation (rTMS) for narcolepsy remains unexplored.
PATIENT CONCERNS
In this paper, we present a case of a 14-year-old young girl with excessive daytime sleepiness (EDS), cataplexy and hypnagogic hallucinations.
DIAGNOSES
After excluding other possible medical conditions, this patient was primarily diagnosed with narcolepsy.
INTERVENTIONS
The patient received 25 sessions of high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC).
OUTCOMES
The symptoms of EDS and cataplexy significantly improved after rTMS treatment. Meanwhile, her score in the Epworth sleep scale (ESS) also remarkably decreased.
LESSONS
This case indicates that rTMS may be selected as a safe and effective alternative strategy for treating narcolepsy-like symptoms. Well-designed researches are warranted in future investigations on this topic.
理论依据
发作性睡病是一种罕见的睡眠障碍，睡眠结构紊乱。发作性睡病的临床管理主要依赖于症状驱动的药物治疗。重复经颅磁刺激（rTMS）对发作性睡病的治疗作用仍未得到探索。
患者情况
在本文中，我们报告了一例14岁年轻女孩，有日间过度嗜睡（EDS）、猝倒和入睡前幻觉症状。
诊断
排除其他可能的疾病后，该患者初步诊断为发作性睡病。
干预措施
患者接受了25次针对左侧背外侧前额叶皮质（DLPFC）的高频rTMS治疗。
结果
rTMS治疗后，EDS和猝倒症状明显改善。同时，她的爱泼沃斯思睡量表（ESS）评分也显著降低。
经验教训
该病例表明，rTMS可作为治疗发作性睡病样症状的一种安全有效的替代策略。未来对此主题的研究需要精心设计。
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