Narcolepsy, Rare Dream Transtorne
Narcolepsy was first described in approximately 1780, by Westphal and Gelineau as a picture of excessive daytime drowsiness and episodes of muscle weakness triggered by emotions.
This pathology significantly affects patients in their personal and labor relationships, being able to unemployment, loss of self – esteem and other effects. According to different studies, narcolepsy affects the quality of life than Parkinson’s disease or epilepsy.
Narcolepsy is a relatively frequent disease and its incidence is 0.2 – 1.6/1000, depending on epidemiological studies carried out in Europe, the United States and Japan, the disease begins in adolescence, the symptoms appear progressivelyAnd it is diagnosed late because patients consult many years after the appearance of excessive daytime drowsiness. Clinically it is characterized by a symptomatic tetrad. Irresistible sleep accesses have a variable duration and ensure a normal level of surveillance during a period that varies according to each subject, the episodes of automatic behavior that coincide with drowsiness are also common.
Sometimes patients with this disorder mainly lose their self – esteem because they fight disease alterations, patients generally consider staying away from the outside world to avoid what they consider "discomfort".
Narcolepsy is also known as Gelineau syndrome characterized by daytime drowsSymptoms, this disorder is accompanied by cataplejía and appears in 60-90% of patients, is the symptom that appears most after drowsiness, is described as episodes of muscle weakness caused by strong emotions, since it may be laughing, crying orfeeling shame at that time, when it appears.
It is a chronic sleep disease due to a lack of hypocretinérgic hypothalamic neurotransmission, through a loss of neurons responsible for producing hypocritone. This mechanism in which neurons are destroyed partially points to an autoimmune process;Environmental factors would be responsible for the selective destruction of neurons containing hypocretin, although there is not really evidence to prove this mechanism.
Symptoms
Doctors identify that the symbolic indication of narcolepsy is diurnal drowsiness, being the first indication to leave during the granazón of everyday activities that do not require physical watery, such as manipulating or speaking.
Persistence, of irresistible attacks of unreality are usually approximately 20 minutes, this persists throughout life, although it is known that it can attenuate over time. Other specific symptoms are the cataplejía and insensitivity of unreality, characterized by muscle atonies, in which consciousness is maintained, these episodes can be caused by strong emotions that appear spontaneously
The symptoms that are associated with this can be concern when breathing, sweat, palpitations, and tremors that are usually confused with seizures, which can enter 20 to 30 seconds.
Hypnagogical and hypnopompic hallucinations are pseudoalucinatory phenomena that are presented to the crossbar of unreality or the periquete to wake up, they have a persistence of one minute approximately more or less than 40 patients with narcolepsia ll suffer, they are semi -finished actions such as jerrigonza and inappropriate mystery,Determine objects in wrong places. There are also other symptoms that are except for commonly common deterioration such as headaches, gift spines and concentration, there is still the deterioration of REM mood in which energy of the motor system of violent and aggressive character prevails.
Causes
The cause of narcolepsia is still unknown, but in recent years scientists have made considerable progress to understand their pathogenesis and identify the genes strongly associated with the disorder.
Genetic factors
It has been found that the HLA-DQB1 allele of the HLA-DQB1 human gene is 90% of patients. People with narcolepsy usually have a small number of neurons that produce hypocretin protein, which are responsible for controlling appetite and sleep patterns. Only between 10,000 and 20,000 brain cells secrete hypocretin molecules.
Evolutionary factors
Narcolepsy could be an evolutionary atavism;The appearance of ancestor behavior. According to this theory, ReM dream is the evolution of the defense mechanism known as tonic immobility.
Other factors seem to play important roles in the development of narcolepsia. It is known that some rare cases are due to traumatic lesions to parts of the brain involved in the REM or the growth of tumors and other disease processes in the same regions. Infections, exposure to toxins, food factors, stress, hormonal changes such as those that occur during puberty or menopause and alterations in a person’s sleep scheme are just some of the many factors that can exert direct or indirect effects on thebrain, possibly contributing to the development of the disease.
Impact
- Obesity: People with a disorder are more likely to have obesity due to the lack of hypocretin since sleeping little alters metabolism.
- Interruption of sexual relations: sleep decreases and produces little desire to practice sex and this would generate a problem with the couple.
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- Memory and attention: Cognitive performance, lack of attention can decrease and reduce the ability to retain learning.
- Physical damage and labor problems: there is a risk of falling asleep while driving or homemade accidents, such as burn when cooking, falling. And in labor problems can decrease productivity at work and work performance.
Treatments and medications
- Stimulating: These medications are drugs that stimulate the central nervous system and are the main treatment to help people suffering from narcolepsia so that they remain awake during the day. Doctors usually try fashion or armodafinyl to treat narcolepsia first because these medications are not as addictive as other stimulants and do not produce ups and downs that are often gathered with the first old stimulants. These medications are also induced for cognition because they improve mental function and can balance mood, thus reducing blood pressure so fashionfinyl, which is a drug created for the treatment of some sleep disorders such as narcolepsia or obstructive apneaDream improves cognitive performance, attention capacity, creativity, but has side effects that are rare and include headaches, nausea or anxiety. In other extreme cases some people require a treatment with methylphenidate or also different amphetamines that are very effective, but they can compete an addiction in people and thus cause side effects of nervousness or heart palpitations,
- Antidepressants: narcolepsia negatively impacts the quality of life of people and also the stimulating drugs that are used to control excessive daytime drowsiness, much more often antidepressants are recommended to relieve cataplejía. There is no case in which antidepressants contain some beneficial effect on narcolepsia and there is little evidence to support the use of antidepressant drugs to treat this symptoms.
- Selective serotonin reuptake inhibitors or serotonin and norepinenialine reception inhibitors. They often recipe these medications that counteract sleep with rapid eye movements that relieve cataplexia symptoms, hypnagogical hallucinations and sleep paralysis. Include fluoxetine and venlafaxin. Negative effects may include weight gain, insomnia and digestive problems.
- Tricyclic antidepressants. There is the protription, imipramine and clomipramine, are effective, and in side effects the dryness of mouth and the feeling of fading happen.
- Sodium oxibato (xyrem). It is very effective in treating cataplexia, helping to improve night sleep, which is almost always poor in narcolepsia. Taking high doses, it can also help control day drowsiness and its side effects are nausea, nightly enuresis and worsening of sleepwalking and if they ingest this medication together with other sleeping medications, narcotic analgesics or alcohol can cause discomforts as lack of ease for easeBreathe, comma and death.
Conclusions
Narcolepsy is a sleep disorder that was first described in 1780, in which different symptoms such as excessive daytime drowsiness are manifested, with irresistible sleep episodes, accompanied by cataplejía, which is the loss of muscle tone, this disorder affectsFrom 25 to 50 people per 100.00 inhabitants. Since the treatment of narcolepsia must be individualized
Since the treatment of narcolepsia should be analyzing the symptoms of each patient, early identification by primary care doctors and specialists for better management and monitoring of patients is essential.
It can be concluded that narcolepsia has a detrimental impact on interpersonal relationships, the socialization of the individual who suffers from it, the daily activities that carry out and its success as a workforce, largely due to the lack of information about this condition,which affects the normal development of the narcoleptic individual as marked, as its drowsiness episodes
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