Narcolepsy is an ailment characterized by malfunctions inParadoxical, that is, a quick dream. Narcolepsy manifested increased drowsiness and unforeseen "attacks" of sleep. In addition, this ailment is characterized by daytime "attacks" of overwhelming drowsiness, attacks of a sharp loss of muscle tonus in the presence of consciousness, the disruption of a night's sleep, when falling asleep hypnagogic and when awakening hypnagogic hallucinations. Sometimes transient bodily paralysis can be noted right after awakening. Often, the described condition appears in young males. According to certain assumptions narcolepsy has a hereditary nature in conjunction with a provoking factor from the outside, (viral infection).
Causes of narcolepsy
The etiological factor of the disorder in questionUntil recently, was poorly studied. Scientists have proposed many hypotheses and put forward various concepts. And only by the end of the 20th century they were able to establish the likely factor that influences the formation and further progression of the syndrome under consideration.
Narcolepsy, what is it? According to studies of specialists, narcolepsy originates when there is a violation in the metabolic processes that result in the brain. These disorders lead to a deficient synthesis of the orroxine neuropeptide that regulates the wakefulness of sleep. As a result of this, a person is attacked by attacks of a strong desire to sleep.
The human brain is a complex"mechanism". Pavlov also proved that in the human brain there are deep structures responsible for dreams. It also has neurotransmitters, which make it easy to carry out impulses along neurons. With the normal functioning of the nervous system, these substances are responsible for staying
In a waking state. With their deficiency, the impulses of excitation do not reach the neurons and the subject falls asleep.
Thus, the narcolepsy disease under consideration arises as a result of a deficiency in the neurotransmitter of orexin. The shortage of its production can give rise to the following conditions:
- genetic predisposition;
- hormonal failures during pregnancy or during lactation;
- traumatic brain injury;
- excessive fatigue and strong nervous overexertion;
- infectious processes that penetrate the brain.
These factors cause a violation of the production of orexin, which generates the syndrome of disturbance of paradoxical sleep.
According to a different concept, narcolepsy can beHave an autoimmune cause of occurrence. This is confirmed by the presence of pathological T-lymphocytes, which are absent in healthy subjects. Often narcolepsy is born after vaccination.
The carried out researches of dreams by means of computer complexes have shown that in persons suffering from the described violation, premature onset of the stage of fast sleep is noted.
Symptoms of narcolepsy
The main clinical manifestations ofNarcolepsy is considered an irresistible craving for sleep, manifested by a sudden bout of sleepiness (hypnolepsy). Patients of this condition describe as a strong uncontrollable drowsiness, which inevitably leads to falling asleep regardless of the location of the patient. Often described seizures occur when performing monotonous movements in a monotonous environment (for example, when reading, listening to lectures). Even in healthy individuals, under such circumstances, attacks of drowsiness may occur, however, patients suffering from narcolepsy are "harassed" by sleep in conditions of intense vital activity, for example, while driving a car, for eating.
The frequency of hypnoleptic seizures is characterized bySignificant fluctuations. Their duration can vary from a couple of minutes to three hours. In this case, to awaken an individual who is in a narcoleptic dream is quite simple, as if he is in a usual dream. As a rule, after such a dream, the sick feel themselves rested and quite vigorous, but after a couple of minutes, the attack can repeat itself. Over time, subjects suffering from the described violation, adapt to their ailment, so feeling a characteristic drowsiness, they manage to find a more or less acceptable place to sleep.
In addition to the attacks of sleepiness that occur during the day, the described ailment also manifests itself as a violation of night dreams.
Symptoms of narcolepsy can be as follows: Constant interruptions of dreams at night, bright dreams, insomnia, a feeling of lack of sleep after waking up in the morning. Poor sleep at night causes a decrease in efficiency and ability to focus attention, provokes the appearance of drowsiness during the day and
, Contributes to the intensification of interpersonal confrontations, the emergence of depressive states,
When falling asleep or before awakening, individuals suffering from the described violation can observe hypnagogic phenomena such as: bright visions,
, Often of a negative nature. These phenomena are similar to dreams that occur during the fast sleep phase. In children, such phenomena are considered the norm, in healthy adults they are quite rare.
About a quarter of narcolepticsMarked sleep paralysis, concluded in the muscle weakness of a temporary nature, which prevents the execution of arbitrary actions. Such paralysis, as a rule, occurs in the course of falling asleep or on waking. Most patients complain that, in the described state, they experience the strongest
. In this case, muscular hypotension during sleep paralysis resembles the position of skeletal muscles in the stage of fast sleep.
Narcolepsy and cataplexy, what is it? In addition, approximately 75% of narcoleptics have a phenomenon of cataplexy - a short-term paroxysmal loss of muscle tone, which leads to the fall of the individual against the background of the preservation of consciousness. Usually this symptom provokes sudden emotional reaction of the patient.
Thus, the typical signs of narcolepsy are a "falling asleep" (that is, the subject falls asleep unconsciously) and a sharp involuntary muscle weakness.
There are 4 varieties of the described disease. The primary form of this disorder is the classical variation of narcolepsy, which occurs with daytime attacks of hypersomnia, cataplexy, hallucinations and sleep paralysis.
Secondary form is considered a more rare species. It occurs due to brain damage, brain tumor processes, multiple sclerosis, infectious lesions of brain structures.
The paroxysmal form of the described ailment is associated with
. Narcoleptic paroxysmal seizure is a symptom that occurs when epipripeds. He is in a sudden falling asleep and falling.
Narcolepsy without the appearance of cataplexy - alsoA rare variation of the ailment. It is characterized by two variants of percolation. The first - cataplexy is absent, but there are episodes of fast sleep, detected through diagnostic tests, the second - cataplexy and episodes of fast sleep are absent.
Narcolepsy in children
The ailment of narcolepsy in childrenIs rarely diagnosed, as a result of which the drug for narcolepsy is appointed late. It is believed that narcolepsy has a hereditary genesis. However, due to insufficient knowledge of this disorder, it is impossible to name the exact etiologic factor and the nature of its origin. Therefore, all assumptions about the genesis of narcolepsy are only theoretical.
Most experts agree thatThe described disorder is due to a deficiency of orexin, which is an active substance, which is fundamental in the regulatory function of the processes of awakening and falling asleep.
Factors affecting the presence and severity of certain symptoms include:
- Brain diseases that are infectious in nature;
- trauma to the skull; - Pituitary dysfunction;
- use of funds affecting the central nervous system, including pharmacopoeial drugs;
- violation of the order of sleep and the period of wakefulness;
- severe overwork.
Below are the main signs of narcolepsy, having found out which parents should take care of their children.
First of all, babies suffering from narcolepsy,Lazy and inactive. They often want to sleep during the day, they can "fall" into a dream after eating or while performing monotonous actions. Such babies are difficult to wake up in the morning. They for a long period after awakening remain sleepy and inhibited, often are aggressive and irritable.
Having found out the below listed signs and symptoms of narcolepsy, the treatment of children should be strictly carried out by specialists.
First of all, to this list of symptoms should be attributed to the sharp weakness of the muscles that arises after a violent emotional reaction of the child, the fall of the baby with a safe
So, the main clinical symptoms of narcolepsy are:
- an insuperable daytime drowsiness that occurs suddenly and often at a rather inopportune moment;
- sudden weakness, arising on the background of vivid emotions (cataplexy);
- a short state of stiffness after a sudden awakening (paralysis);
- hallucinations that occur when trying to fall asleep or just before awakening;
- bifurcation in the eyes;
- frequent night waking at night;
- inability to focus on anything;
- constant head algy;
To talk about narcolepsy, you do not needAll these manifestations simultaneously. The listed signs can be manifested in varying degrees of intensity. A mandatory "attribute" of the described disorder is daytime drowsiness in conjunction with one of the above symptoms. As the escalation of the disease joins other symptoms.
This disorder can negatively affect the learning activity of crumbs. It can also cause a delay in physical formation.
There have been cases when children who haveDiagnosis of narcolepsy, also suffer from symptoms of restless legs or nighttime apnea. Parents who notice these manifestations should immediately consult a doctor-somnologist in order to conduct polysomnography.
How to treat narcolepsy, many moms and dadsAre interested. Today, the described disorder belongs to the category of incurable ailments. Help babies suffering from narcolepsy is similar to the therapeutic measures performed for adult patients.
Treatment of narcolepsy
After a primary examination by a neurologistTo confirm or exclude a diagnosis narcolepsy of the patient is sent for examination to a somnologist who will thoroughly study the features of the course of the disease and will conduct specific tests.
First of all, a multiple test is conductedQuantitative assessment of daytime sleepiness (MSLT) and the technique of recording during sleep activity indicators (polysomnography). In order to investigate the disease through polysonography, the patient should spend the night in a specialized room under medical supervision, since this technique is aimed at studying night sleep. This method allows detecting disturbances in the sequence of sleep phases, as well as excluding another possible pathology.
The test should be conducted in the afternoon after nightResearch. The patient falls asleep for about 20 minutes. Within two hours of such periods of falling asleep there will be several. While the patient is pushing, changes in the face pattern are recorded. The combination of the described research techniques allows the somnologist to diagnose narcolepsy.
So, how to treat narcolepsy?
Modern therapeutic methods todayCompletely cure described ailment can not, but they can significantly alleviate the symptoms, which gives the patient the hope of a normal life.
The medical measures, first of all, are based on the complex approach, which includes medical therapy, changing the order of life, support for relatives, methods
Individuals diagnosed with narcolepsy,It is recommended to adhere to the constant order of sleep, that is, to fall asleep and wake up should be at a certain time every day. Most patients are most suited to a scheme based on an eight-hour night's sleep, and should also include 2 fifteen-minute daytime sleep. In order to improve the quality of night dreams, you must exclude the use of heavy foods, alcohol-containing and caffeine-containing liquids, nicotine, as well as eating directly before falling asleep. If narcolepsy is diagnosed, patients should avoid driving. They are also encouraged to change jobs if their conditions are associated with risk or moving mechanical equipment.
Correctly selected drug for narcolepsyHas a stimulating effect in the daytime, thus eliminating the problem of invariably present drowsiness. To eliminate the difficulties with periods of fast sleep at night, antidepressant medications are prescribed, giving the body the opportunity to relax and revive the order of dreams and wakefulness.
Treatment of narcolepsy, characterized by daytime drowsiness in mild or moderate form, begins with an analeptic Modafinil, stimulating a state of wakefulness that does not cause
If treatment with modafinil narcolepsy is susceptibleBad, then prescribe amphetamine preparations, for example, Methylphenidate or Methamphetamine. However, these medications should be taken with extreme caution, since they have a number of negative consequences in the form of rapid contractions of the myocardium, excitation, hypertension, addiction, which can develop into dependence.
Lowering the incidence of cataplexy is helped by the use of tricyclic antidepressants, for example, Imipramine.
Since narcolepsy is symptomaticViolent emotional outbursts, narcoleptics is recommended to practice all possible relaxation techniques, including respiratory gymnastics, yoga exercises, massage.