发作性睡病:附17例临床分析

Childhood narcolepsy: A clinical analysis of 17 cases

本文回顾性总结了我院儿科自1987年以来收治的发作性睡病共17例,结果表明症状以睡眠过多及不可抗拒的睡眠发作最多(17例),以下依次为猝倒症(16例)、睡眠幻觉(12例)及睡瘫症(2例),有典型四联症的病人仅2例。影像学检查均无特殊改变。普通睡眠脑电图13例中有3例呈界限性改变;查24小时脑电图6例,其中5例有睡眠—醒觉周期改变,REM睡眠占全部睡眠时间的49～62％,提示24小时脑电图较普通睡眠脑电图对诊断发作性睡病意义较大。

The authors have retrospectively studied 17 children with narcolepsy admitted to our department since 1987. The clinical data showed that the most important symptoms found in this group were sleep attacks (17), followed by cataplexy (16), hyponagogic hallucination (12) and sleep paralysis (2), although the typical tetrasymptoms of this disease could be only seen in 2 patients. Furthermore, all the patients, except 1 case, showed no specific changes in CT and MRI scanning examinations. Significantly, 5 patients were discovered to have the change in sleep-wakening circle and their REM sleep was observed to be as long as 49-62% of whole sleep time in 6 cases who received 24-hours dynamic EEG, but, otherwise, only boundary alteration could be found in 3 of 13 cases when receiving common sleep EEG. The authors, therefore , suggests that 24-hours dynamic EEG should be taken as a availably-used diagnostic tool for the doubtful patients with narcolepsy, because the data obtained above indicates that it could play a more important role than common sleep EEG in the diagnosis. The diagnosis and treatment of the disease were also briefly discussed herein.