Pathophysiology, Clinical, and Therapeutic Aspects of Narcolepsy

Yıl 2014, Cilt: 6 Sayı: 3, 271 - 283, 06.11.2014

Pınar Güzel Özdemir Yavuz Selvi Tezay Çakın Güleç Mustafa Güleç

https://doi.org/10.5455/cap.20140115073522

Öz

Narcolepsy is a lifelong sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination, and sleep paralysis. The exact cause remains unknown, but there is significant evidence that hypocretin deficiency plays an integral role. There have been advances in the understanding of the pathogenesis of narcolepsy. It has a negative effect on the quality of life and can restrict the patients from certain careers and activities. Diagnosis relies on patient history and objective data gathered from polysomnography and multiple sleep latency testing. Treatment focuses on symptom relief through medication, education, and behavioral modification. Both classic pharmacological treatments as well as newer options have significant problems, especially because of side effects and abuse potential. Some novel modalities are being examined to expand options for treatment. In this review, the pathophysiological, clinical, and pharmacotherapeutic aspects of narcolepsy are discussed.

Anahtar Kelimeler

Narcolepsy, cataplexy, hypocretin, treatment

Narkolepsinin Fizyopatolojisi, Klinik Görünümü ve Tedavi Yaklaşımları

Öz

Narkolepsi aşırı gündüz uykululuğu, katapleksi, hipnogojik varsanı ve uyku paralizisi ile giden ve ömür boyu devam eden bir uyku bozukluğudur. Kesin nedeni bilinmemektedir ancak hipokretin eksikliğinin önemli rol oynadığına dair önemli kanıtlar vardır. Narkolepsinin patogenezini anlamada ilerlemeler kaydedilmiştir. Hayat kalitesine olumsuz etkisi vardır ve hastaları belirli kariyer ve aktivitelerden de kısıtlayabilir. Tanı hastanın öyküsüne ve polisomnografi ve çoklu uyku latans testi ile toplanan nesnel verilere dayanır. Tedavi medikal, eğitim ve davranış değişikliği ile semptomlarda rahatlamaya odaklanır. Yeni seçeneklerin yanı sıra klasik farmakolojik tedavinin de yan etki ve kötüye kullanma potansiyeli gibi önemli sorunları vardır. Bazı yeni yöntemler tedavi seçenekleri genişletmek için araştırılmaktadır. Bu derlemede, narkolepsinin, patofizyolojik, klinik ve farmakoterapötik yönleri tartışılmıştır.

Anahtar Kelimeler

Narkolepsi, katapleksi, hipokretin, tedavi

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