Sleep Med Psychophysiol.
2000 Dec;7(2):115-119.
Narcolepsy Variant Presented with Difficult Waking
- Affiliations
-
- 1Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
- 2Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
OBJECTIVES
SUMMARY: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis.
METHODS
Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out.
RESULTS
The PSG showed short sleep latency (4.0 min)and REM latency (2.5 min). increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21sec) and 4 times sleep-onset REM(SOREM). HLA-typing showed DQ6-positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients(DQB1*0602 and DQA1*0102).
CONCLUSION
Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a varient type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic maker.
