narcolepsy

Question 1

what is narcolepsy?

Answer 1

rare chronic sleep disorder characterised by abnormal rapid eye movement (REM) sleep

Question 2

what are the presentations of narcolepsy?

Answer 2

cataplexy
- sudden collapse due to loss of muscle control

exessive daytime somnolence(sleepiness)

hypnagogic/ hypnopomic hallucinations (occuring before falling asleep/ before waking up)

sleep attacks

sleep paralysis

Question 3

what investigation is used that is the same as oba?

Answer 3

polysomnograph

Question 4

what investigations are used to diagnose narcolepsy?

Answer 4

multiple sleep letency test
> SOREM and mean sleep latency <8 minutes
- patients begin sleep cycle with REM stage which occurs in a normal state after 90 minutes

low CSF levels of hypocretin (i.e orexin)
- neuropeptide associated with wakefulness state, opposite.

Question 5

what is the first line stimulant for narcolepsy?

Answer 5

e.g. modafinil

Question 6

what is the second line stimulant for narcolepsy?

Answer 6

e.g. dexamphetamine

Question 7

what is the first line treatment for cataplexy?

Answer 7

venlafaxine

Question 8

what is the second-line treatment for cataplexy?

Answer 8

sodium oxybate