The current understanding of narcolepsy is that it begins with an underlying genetic predisposition a person is born with certain genes that put them at greater risk for developing narcolepsy. This is why antidepressants (which act on these neurotransmitters) are sometimes prescribed for narcolepsy. The loss of hypocretin also affects the action of other key chemicals in the brain, such as dopamine, serotonin, and norepinephrine.
Without hypocretin, it’s hard for a person to stay awake for long periods of time, and they experience overlaps between waking and sleep-such as vivid hallucinations and paralysis when falling asleep or waking up. Even though it’s a relatively small cluster of cells, the impact on waking and sleep is dramatic. In a person with narcolepsy, the cells in this specialized region of the hypothalamus have died off. Hypocretin activates and maintains the action of those alerting signals coming from the brain stem. These signals spread out and “wake up” the rest of the brain. Normally, alerting signals come from the brain stem, a region deep in the brain responsible for many basic functions. Hypocretin is a chemical in the brain that is important for regulating wakefulness and rapid eye movement (REM) sleep. The reason for this is not fully understood, but it is thought to be an autoimmune process possibly triggered by an infection 3). Narcolepsy with cataplexy (narcolepsy type 1) has a known cause, related to a loss of cells in the hypothalamus of the brain that secrete the chemical hypocretin (also called orexin) 2). Age of onset peaks at 15 and again at 35 years with a 1.6:1 male predominance 1). Prevalence is 25 to 50 per 100,000 people for narcolepsy type 1 (narcolepsy with cataplexy) and 20 to 34 per 100,000 people for narcolepsy type 2 (narcolepsy without cataplexy). Injuries to the hypothalamus and brain stem, tumors, and stroke are under investigation. Narcolepsy without cataplexy (narcolepsy type 2) includes most of the same symptoms, but its cause is unknown. However, developing narcolepsy is a complex process of genes and triggering events therefore, many family members of a person with narcolepsy may not have it. Since narcolepsy has an underlying genetic component, family members of people with narcolepsy are at a slightly increased risk of developing the disorder. Narcolepsy usually has its onset in childhood or adolescence. Narcolepsy is often accompanied by cataplexy (narcolepsy type 1), a sudden loss of muscle control that can cause a person to collapse, slump over, or slur words without much warning. There are two types: narcolepsy type 1 (formerly narcolepsy with cataplexy) and narcolepsy type 2 (formerly narcolepsy without cataplexy). Narcolepsy is a sleep disorder of rapid onset rapid eye movement (REM) sleep that is characterized by excessive sleepiness, daily uncontrollable sleep attacks, sleep paralysis, hypnagogic hallucinations and, for some, sudden loss of muscle control (cataplexy). Some of these medications also have the added benefit of helping with hallucinations and sleep paralysis. Where you fall in that spectrum, as well as other health considerations, will determine whether your doctor suggests a medication for cataplexy. Some people with narcolepsy never experience an episode of cataplexy, while others have multiple episodes per day. The severity of cataplexy symptoms varies.
CATAPLEXY FACE FULL
In the case of cataplexy, that characteristic of REM sleep occurs suddenly during the day, causing weakness or full paralysis, even as the person remains awake during the episode. During normal rapid eye movement (REM) sleep, there is a natural loss of muscle tone. The loss of muscle tone in cataplexy occurs because of the inability to regulate sleep and awake states - meaning that elements of each can overlap. Some individuals avoid emotions that may bring on cataplexy. The frequency of cataplexy episodes varies widely among people with narcolepsy.
These episodes last up to a minute or two, and some people may fall asleep afterwards. A person experiencing total cataplexy stays awake and is aware of what is happening, but cannot move. Without much warning, the person loses muscle tone and can have a slack jaw, broken speech, buckled knees or total weakness in their face, arms, legs, and trunk. Cataplexy is a sudden and uncontrollable muscle weakness or paralysis that comes on during the day and is often triggered by a strong emotion, such as excitement or laughter.
0 kommentar(er)
