Explanation of Narcolepsy

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Explanations of Narcolepsy

Knowledge

Psychological explanations

> LEHRMAN AND WEISS suggested that sudden attacks of sleepiness disguise sexual fantasies.

REM

> One of the classic symptoms of narcolepsy is loss of muscle tone (called 'cataplexy') - this is similar to what happens during REM sleep.

> During the daytime narcoleptics often experience intrusions of REM-type sleep (hallucinations) & at night narcoleptics have abnormal REM sleep.

> In the 1960's an explanation offered for narcolepsy was that it was caused by a malfunction in the system that regulates REM sleep.

HLA

> In the 1980's research pointed in a new direction, suggesting that narcolepsy linked to a mutation of the immune system.

> HONDA ET AL. found increased frequency of one type of HLA (human leukocyte antigen) in narcoleptic patients.

> HLA molecules are found on the surface of white blood cells and coordinate the immune response.

> Recent research has found that more than 90% of people suffering from narcolepsy with cataplexy have been found to have the HLA variant HLA-DQB1*0602.

Hypocretin

> Most recently research has uncovered a link between a neurotransmitter (hypocretin) and narcolepsy.

> Hypocretins regulate sleep and wakefulness through interactions with systems that regulate emotion and homeostasis in the hypothalamus.

> Normally there're about 10,000-20,000 hypocretin-producing cells in the hypothalamus but in many narcoleptics a large number of these cells are missing, resulting in low levels of hypocretin.

Evaluation

REM

> VOGEL observed REM sleep at the onset of sleep in a narcoleptic patient, whereas…

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