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2007 Martínez-Rodríguez JE Convertir en PDF 

Comparative analysis of patients with narcolepsy-cataplexy, narcolepsy without cataplexy and idiopathic hypersomnia.

 

Martínez-Rodríguez JE, Iranzo A, Casamitjana R, Graus F, Santamaria J.

 Servicio de Neurología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, España.

 

Cette étude montre que les narcoleptiques avec cataplexie présentent également le plus souvent une taux indétectable d'hypocrétine dans le liquide céphalo rachidien, une nuit fragmentée, un HLA DQB1*0602 positif, des siestes courtes et récupératrice...

Les 2 critères de l'hypersomnie idiopathique : nuit de longue durée et ivresse de sommeil n'était pas en proportion différente dans les 3 groupes (mais ceci pourrait être expliquée par les faibles effectifs des groupes rendant l'analyse statistique délicate).

 

Martínez-Rodríguez JE, Iranzo A, Casamitjana R, Graus F, Santamaria J.
[Comparative analysis of patients with narcolepsy-cataplexy, narcolepsy without cataplexy and idiopathic hypersomnia]
Med Clin (Barc). 2007 Mar 17;128(10):361-4. Spanish.

 

     Résumé en anglais

BACKGROUND AND OBJECTIVE: To evaluate the distribution of clinical, electrophysiological and biological variables, and their relationship with the CSF hypocretin-1 levels, in patients with central hypersomnias diagnosed as narcolepsy-cataplexy (NC), narcolepsy without cataplexy (NnC) and idiopathic hypersomnia (IH) based on the ICSD-2 criteria.

PATIENTS AND METHOD: We performed in all patients a clinical interview, a nocturnal polysomnogram and a multiple sleep latency test (MSLT), HLA analysis and measurement of CSF Hcrt-1 levels (low < or = 110 pg/mL).

RESULTS: Out of 51 patients, 31 were classified as NC, 11 as NnC and 8 as IH. 34 patients (66.7%) had low CSF Hcrt-1 levels (29 NC, 3 NnC and 1 IH). In the NC group, 96.1% were HLA DQB1*0602 positive and 91% had low CSF Hcrt-1 levels. The most frequent variables found in NC patients and in those with a low CSF Hcrt-1 levels were cataplexy, fragmented nocturnal sleep, short refreshing naps, automatic behavior, HLA DQB1*0602, and, in the MSLT, a short mean sleep latency, a higher number of REM sleep episodes and a short mean latency of REM sleep episodes. A long nocturnal sleep time and morning sleep drunkenness, 2 variables used in the ICSD-2 for the diagnosis of IH, were not different among the three groups of hypersomnias.

CONCLUSIONS: Central hypersomnias have a superposition of several clinical, electrophysiological and biological variables that makes sometimes difficult the differential diagnosis. The measurement of CSF Hcrt-1 levels may help in the diagnosis of those patients with unclear clinical or electrophysiological forms.

 

Dernière mise à jour : ( 06-04-2010 )
 
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