The Pathophysiologic Basis of Secondary Narcolepsy and Hypersomnia

The Pathophysiologic Basis of Secondary Narcolepsy and Hypersomnia

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Takashi Kanbayashi & Yohei Sagawa & Fumi Takemura & Sachiko-Uemura Ito & Ko Tsutsui & Yasuo Hishikawa & Seiji Nishino
  • چاپ و سال / کشور: 2011

Description

The symptoms of narcolepsy can occur during the course of other neurologic conditions (ie, symptomatic narcolepsy). Inherited disorders, tumors, and head trauma were the three most frequent causes for symptomatic narcolepsy. Other causes include multiple sclerosis (MS), vascular disorders, and encephalitis. Cerebrospinal fluid hypocretin-1 measures were carried out in some recent cases with symptomatic narcolepsy, and moderate decreases in hypocretin levels were seen in a large majority of these cases. Excessive daytime sleepiness (EDS) in these symptomatic cases was sometimes reversible with an improvement of the causative neurologic disorder and with an improvement of the hypocretin (orexin) status. Recently, we found that several symptomatic narcoleptic cases withMS show unique bilateral symmetric hypothalamic lesions associated with significant hypocretin ligand deficiency. In addition, these patients often share the clinical characteristics of neuromyelitis optica (NMO) and the detection of NMO-IgG (or anti-aquaporin-4 [AQP4] antibodies), suggesting a new clinical entity. Further studies of the involvement of the hypocretin system in symptomatic narcolepsy and EDS are helpful to understand the pathophysiologic mechanisms for occurrence of EDS and cataplexy.
Curr Neurol Neurosci Rep (2011) 11:235–241 DOI 10.1007/s11910-011-0178-y Published online: 8 February 2011
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