Narcolepsy

Narcolepsy is a paroxysm of insurmountable drowsiness with the development of dependence on the external situation.

Etiology. The disease either has the character of idiopathic suffering of an unknown nature (sometimes genetically determined), or is associated with damage to the hypothalamus and brainstem (tumor, encephalitis).

Pathogenesis. Dysfunction of the reticular system.

Symptoms, course. Repeated bouts of sleep, no different from normal, but arising in an inadequate situation. Duration of sleep usually several minutes, occasionally up to several hours, the frequency of paroxysms from one to several during the day. Many patients suffer from cataplexy, in which, against a background of clear consciousness, the muscle tone turns off, which leads to a fall; Cataplexy in most cases is provoked by bright positive and negative emotions (laughter, anger). Close to cataplexy, the symptomatic complex is drowsy paralysis: episodes of the impossibility of movements within a few minutes of waking up; More rare symptoms: hypnagogic hallucinations (hallucinations when falling asleep), psychotic episodes, somnambulism, diplopia during sleep paralysis, disturbance of night sleep. Increased daytime drowsiness, resembling narcolepsy, is observed in the syndrome of Pickwick: obesity, pulmonary heart, restless night sleep with periods of apnea and unusually loud snoring. Unlike narcolepsy, there is no cataplexy, no carotid paralysis in this syndrome.

Treatment. Psychostimulants (sidnokarb, sidnofen, centedrin), melipramine (blocks cataplexy), large doses of beta-blockers (anaprilin); To improve night sleep - radedorm.