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Available from: Yves Dauvilliers, Dec 09, 2014
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    • "Five narcolepsy with severe psychosis cases were examined and also included (group B), because autoantibody-mediated mechanisms (anti-Ma2, anti-aquaporine 4 antibodies) are suspected in some secondary narcolepsy cases [10,11]. In addition, several research groups recently reported that a swine flu (H1N1) vaccination increased the incidence of hypocretin-deficient narcolepsy [12]. The antibody levels of 10 narcolepsy cases without psychosis were additionally measured for comparison with group B. We also examined the antibody in 51 patients with schizophrenia or schizo-affective disorders (group C). "
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    ABSTRACT: Causative role of encephalitis in major psychotic features, dyskinesias (particularly orofacial), seizures, and autonomic and respiratory changes has been recently emphasized. These symptoms often occur in young females with ovarian teratomas and are frequently associated with serum and CSF autoantibodies to the NMDA receptor (NMDAR). The study included a total of 61 patients from age 15 to 61 and was carried out between January 1, 2005, and Dec 31, 2010. The patients were divided into the following three clinical groups for comparison. Group A; Patients with typical clinical characteristics of anti-NMDAR encephalitis. Group B; Patients with narcolepsy with severe psychosis. Group C; Patients with schizophrenia or schizo-affective disorders. Ten out of 61 cases were anti-NMDAR antibody positive in typical encephalitis cases (group A: 3 of 5 cases) and cases in a broader range of psychiatric disorders including narcolepsy (group B: 3 of 5 cases) and schizophrenia (group C: 4 of 51 cases). In addition to 3 typical cases, we found 7 cases with anti-NMDAR antibody associated with various psychotic and sleep symptoms, which lack any noticeable clinical signs of encephalitis (seizures and autonomic symptoms) throughout the course of the disease episodes; this result suggest that further discussion on the nosology and pathophysiology of autoimmune-mediated atypical psychosis and sleep disorders is required.
    BMC Psychiatry 05/2012; 12(1):37. DOI:10.1186/1471-244X-12-37 · 2.21 Impact Factor
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    ABSTRACT: Narcolepsy is an autoimmune sleep disease characterized by excessive daytime sleepiness, cataplexy, and intrusive rapid eye movement sleep. Deficit in endogenous orexin is a major pathogenic component of the disease. This disorder is also associated with the gene marker HLADQB1*0602. After the 2009, H1N1 pandemic, a remarkable increased incidence of narcolepsy, especially in children, was noticed in different countries. In Finland and Sweden, this was attributed to the H1N1 vaccine, especially the adjuvanted pandemic vaccines. In China, there was a 3-fold increase in narcolepsy onset but was due to H1N1 virus infection per se. This review will first summarize the epidemiological data of post H1N1 narcolepsy, then possible mechanisms of the H1N1-related immune process to link the HLA (human leukocyte antigen) genetic background and hypocretin deficiency in narcolepsy–cataplexy will be discussed.
    Somnologie - Schlafforschung und Schlafmedizin 06/2013; 17(2). DOI:10.1007/s11818-013-0619-8
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    Sleep 11/2010; 33(11):1426-7. · 4.59 Impact Factor
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