narcolepsy hyperphagia syndrome
Introduction
Brief introduction to narcolepsy Paroxysmal sleepiness syndrome, also known as Kleine-Leine syndrome (KLS), is a rare syndrome. In 1925, Kleine reported a group of patients, all of whom were young men. These people were always asleep when they were sick, except when they were eating and urinating. They were also asleep during sleep, and they could wake up themselves. After waking up, I have to eat immediately, and when I eat, the amount of food is amazing. I eat 2 to 3 pounds a day, and 5 to 6 pounds of food. When I ask why I have to eat so much, The patient will answer without hesitation: "Hungry is uncomfortable." If you don't give something to eat, you will have a lot of noise, and you will not be too much. In 1936 Levin discovered that these patients had a special pathological hunger, so Levin called the disease a periodic sleepiness-pathological hunger syndrome. In 1924, Gritchley and Hoffman also reported 2 cases and named the disease Kleine-Levin syndrome, also known as lethargy- bulimia syndrome. China has also reported this disease in recent years. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: obesity, endocrine disorders
Cause
The cause of narcolepsy
Cause:
The cause is unclear. It is generally considered that inter-brain brain lesions, especially in the hypothalamus, are considered to be a type of snoring, rather than an independent disease. Others believe that the disease is mild and mild. Encephalitis; some people think that it is a kind of epilepsy according to the abnormal EEG of the patient.
Pathogenesis:
According to the study of neurobiochemistry, pathology and physiology in modern medicine, it is believed that the sleep-bitter syndrome is mildly caused by the function of the limbic system-hypothalamus-brain reticular structure, infection and congenital defects. The underlying lesions caused the patient to develop the disease after puberty due to dysfunction of the internal environment and endocrine system.
Prevention
Paroxysmal sleepiness prevention
Avoid high-risk work, such as working at heights and driving. Do not go to dangerous places and engage in dangerous recreational activities such as swimming, climbing, etc.
Early diagnosis, early treatment.
Complication
Complications of paroxysmal sleepiness syndrome Complications, endocrine disorders, obesity
Obesity and the resulting metabolic abnormalities may have endocrine changes, or autonomic dysfunction.
Symptom
Symptoms of narcolepsy and strong eating syndrome Common symptoms Narcolepsy and appetite hyperactivity Neonatal sleepiness and drowsiness
Sudden sleepiness and strong eating syndrome with periodicity, paroxysmal drowsiness and hyperextension as the main symptoms, can cause drowsiness when sleepiness attacks, can blink, but can not talk, indifferent to the surrounding things, easy to be irritated, during the period Often there is an appetite, can wake up to eat, sleep after eating, the amount of diet increased, accompanied by a rapid increase in body weight (up to 1 ~ 2kg per day), with or without psychiatric symptoms, the episode lasts 1 day ~ After 2 weeks of recovery, there was no abnormality in the intermittent period, but it can be repeated, ranging from 2 to 4 months. Some patients may have endocrine changes or autonomic dysfunction.
Physical examination without positive signs, EEG can be normal, can also be expressed as moderate abnormalities, the basic rhythm slows down to 8 ~ 9 times / s rhythm, double frontal area high amplitude wave, single wave, etc., skull CT, MRI scan and cerebrospinal fluid examination were normal.
Examine
Examination of paroxysmal sleepiness syndrome
Laboratory inspection
1, multiple sleep latency test (MSLT).
2. Polysomnography (PSG) examination.
3. EEG inspection.
Auxiliary inspection
1, CT and MRI and other inspections.
2, blood routine, blood electrolytes, blood sugar, urea nitrogen.
3, ECG, abdominal B-ultrasound, chest, thyroid function test.
Diagnosis
Diagnosis and diagnosis of paroxysmal sleepiness syndrome
Diagnostic criteria
According to the typical, periodic episodes of lethargy and appetite, it is not difficult to diagnose. It should be distinguished from narcolepsy. The narcolepsy also has paroxysmal sleepiness, but there is no appetite and it is accompanied by tripping. , sleep sputum, sleep illusion and other symptoms, MSLT showed pathological REM sleep.
At present, there is no objective examination basis for the diagnosis of the disease, mainly based on the diagnostic criteria of the international classification of diseases:
1 A paroxysmal sleep, diet, and behavioral disorder.
2 The seizure period showed obvious lethargy and prolonged sleep time and increased food intake.
3 Unfixed personality changes can be expressed as irritability, hallucinations and depression.
4 The episode lasts for a few days to a few weeks, and the interictal interval is completely normal, while EEG, polysomnography, and sleep latency test are helpful for diagnosis.
Differential diagnosis
Attention should be paid to the identification of narcolepsy. Narcolepsy also has episodic sleepiness, but there is no appetite and accompanied by symptoms such as stumbling, sleep paralysis, and illusion of falling into sleep. MSLT shows that patients with pathological REM sleep have mild EEG abnormalities during the attack. Epilepsy, encephalitis, brain tumors, etc., in addition, in the attack period also need to be differentiated from spontaneous hypoglycemia, hypothyroidism, narcolepsy, periodic psychosis.
