发作性睡病5例临床特征分析

Analysis of Clinical Characteristic of 5 Patients with Narcolepsy

[目的]探讨发作性睡病的临床特征.[方法]对本院5例发作性睡病患者的临床资料进行回顾性分析.[结果]5例患者均无明显诱因及阳性家族史,均有白天过度嗜睡,其中3例伴猝倒,2例有入睡前幻觉.首发症状为白天过度嗜睡2例,猝倒伴白天过度嗜睡3例.实验室及影像学检查均无特殊改变.5例患者均进行整夜多导睡眠图（PSG）检查及多次小睡潜伏期试验（MSLT）检查.PSG结果显示睡眠潜伏期〈10 min,快速眼动睡眠（REM）潜伏期〈20 min.MSLT结果显示所有患者平均睡眠潜伏期〈5 min,其中3例出现2次或2次以上睡眠始发REM睡眠（SOREMPs）,2例未见SOREMPs,但平均REM潜伏期〈10 min.[结论]发作性睡病是慢性神经系统疾病,PSG及MSLT检查可以明确诊断,对患者应给予长期的药物治疗,心理治疗和健康教育。

[Objective] To explore the clinical characteristics of narcolepsy. [Methods] Clinical data of 5patients with narcolepsy were analyzed respectively. [Results] Five patients had no definite inducement and positive familial history. All patients manifested with excessive daytime sleepiness. Cataplexy appeared in 3 cases. Hypnagogic hallucination appeared in 2 cases. The first symptom was excessive daytime sleepiness in 2 cases and cataplexy accompanied by excessive daytime sleepiness in 3 cases. All patients showed no specific changes in the chemical examinations and image examinations. One night polysomnography（PSG） and multiple sleep latency test（MSLT） were done in all the 5 patients. The PSG results showed that sleep latency was less than 10 minutes and rapid eye movement latency was less than 20 minutes in all cases. The MSLT results showed that the average sleep latency was less than 5 minutes in all cases. And three out of the 5 patients had two or more sleep onset rapid eye movement（REM） periods（SOREMPs）. Two cases had no SOREMPs. But their mean REM sleep latency was less than 10 minutes. [Conclusion] Narcolepsy is a chronic neurological disorder. One night PSG and MSLT may be useful in the diagnosis of atypical narcolepsy. Long term drug thera- py, psychosocial treatment and health education should be taken to improve the quality of life.