Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology 58, 1826-33

Stanford Sleep Epidemiology Research Center, School of Medicine, Stanford University, CA 94305, USA.
Neurology (Impact Factor: 8.29). 07/2002; 58(12):1826-33. DOI: 10.1212/WNL.58.12.1826
Source: PubMed


To determine the prevalence of narcolepsy in the general population of five European countries (target population 205,890,882 inhabitants).
Overall, 18,980 randomly selected subjects were interviewed (participation rate 80.4%). These subjects were representative of the general population of the UK, Germany, Italy, Portugal, and Spain. They were interviewed by telephone using the Sleep-EVAL expert system, which provided narcolepsy diagnosis according to the International Classification of Sleep Disorders (ICSD).
Excessive daytime sleepiness was reported by 15% of the sample, with a higher prevalence in the UK and Germany. Napping two times or more in the same day was reported by 1.6% of the sample, with a significantly higher rate in Germany. Cataplexy (episodes of loss of muscle function related to a strong emotion), a cardinal symptom of narcolepsy, was found in 1.6% of the sample. An ICSD narcolepsy diagnosis was found in 0.047% of the sample: The narcolepsy was severe for 0.026% of the sample and moderate in 0.021%.
This is the first epidemiologic study that estimates the prevalence of narcolepsy in the general population of these five European countries. The disorder affects 47 individuals/100,000 inhabitants.

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    • "Narcolepsy with cataplexy (NC) is a chronic neurological disease with a prevalence of approximately 0.045% in North America and Europe (Ohayon et al. 2002). The manifestations of NC are excessive daytime sleepiness and cataplexy, and roughly half of patients experience hypnagogic hallucinations and sleep paralysis. "
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    ABSTRACT: We present the case of an 86 year old female, in whom narcolepsy with cataplexy (NC) manifested at 52 years of age. She was treated by an amphetamine-like drug phenmetrazine and tricyclic antidepressants for more than 10 years. Hypokinetic-rigid syndrome manifested at 83 years of age and Parkinson´s disease (PD) was diagnosed. Detailed examination at the age of 86 confirmed the previous diagnosis of NC and the diagnosis of PD. Severe periodic limb movements in sleep, severe sleep apnea, REM sleep behavior disorder and restless legs syndrome, which are frequently comorbid in NC and PD, were revealed. The patient's somnolence worsened, apparently accentuated by pramipexole treatment, as changing therapy to levodopa led to a reduction of sleepiness.
    Neuro endocrinology letters 08/2015; 36(3):226-230. · 0.80 Impact Factor
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    • "Son incidence suit une courbe d'incidence bimodale avec un pic à 15 ans et un second vers 35 ans [5]. Sa prévalence est estimée environ à 0,025 % [6]. Les mécanismes étiopathogéniques de la NSC et de l'HI restent mal connus, contrairement à ceux de la NC. "
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    ABSTRACT: Les symptômes du trouble déficit d’attention avec ou sans hyperactivité (TDA/H) sont fréquemment observés chez les sujets souffrant d’hypersomnie centrale. Les hypothèses physiopathologiques concernant cette association sont discutées : s’agit-il de conséquences de la somnolence diurne excessive ou le reflet d’une vulnérabilité commune entre les hypersomnies et le TDA/H ? Notre travail a pour objectif, d’une part, d’étudier la fréquence du TDA/H chez des sujets souffrant de narcolepsie-cataplexie, narcolepsie sans cataplexie et hypersomnie idiopathique et, d’autre part, d’étudier les déterminants cliniques, biologiques et polysomnographiques de cette association. Ce travail pourrait améliorer nos connaissances sur la physiopathologie de ces troubles.
    Médecine du Sommeil 11/2014; 11(4). DOI:10.1016/j.msom.2014.09.001
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    • "Narcolepsy—genetically associated with HLA DQB1 ⁄ 06:02 (HLA) and the T-cell receptor (TCR)—is caused by the autoimmune destruction of neurons in the hypothalamus that produce the peptide hypocretin (orexin) (hormones that regulate the sleep cycle) [2] [3] [4] [5]. Narcolepsy is rare, occurring in less than one percent of the general population [6]. SP often occurs without narcolepsy (referred to as ''isolated'' sleep paralysis). "
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    ABSTRACT: Sleep paralysis (SP) is a common condition occurring either at sleep onset or sleep offset. During SP the sleeper experiences gross motor paralysis while the sensory system is clear. Hypnogogic and hypnopompic hallucinations are common during SP and may involve seeing, hearing, and sensing the presence of menacing intruders in one’s bedroom. This “intruder” is often perceived as a shadowy humanoid figure. Supernatural accounts of this hallucinated intruder are common across cultures. In this paper, we postulate that a functional disturbance of the right parietal cortex explains the shadowy nocturnal bedroom intruder hallucination during SP. This hallucination may arise due to a disturbance in the multisensory processing of body and self at the temporoparietal junction. We specifically propose that this perceived intruder is the result of a hallucinated projection of the genetically “hard-wired” body image (homunculus), in the right parietal region; namely, the same circuits that dictate aesthetic and sexual preference of body morphology. One way to test this hypothesis would be to study clinical populations who may have genetically acquired “irregularities” in their internal hard-wired body image in the right superior parietal lobule (SPL); for example, individuals with apotemnophilia or anorexia nervosa. If such individuals experience SP (e.g., induced in a sleep lab), and they hallucinate this shadowy figure, one would predict that they would see humanoid shadows and shapes with body irregularities, mirroring their own internal body image morphology. If correct, our hypothesis will offer a neurological explanation for this nocturnal bedroom intruder that has been a source of controversy, and striking and implausible cultural interpretations throughout history. Indeed, if our proposed hypothesis is tested and corroborated, dissemination of such findings would provide great relief to SP experiencers worldwide and could potentially be used in a therapeutic context.
    Medical Hypotheses 10/2014; 83(6). DOI:10.1016/j.mehy.2014.10.002 · 1.07 Impact Factor
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