![]() Larger studies with consistent clinical phenotyping should be the focus of future investigations. Objective (HLA typing, MSLT, and sleep studies) more than subjective (sleepiness and sleep paralysis) features predicted low concentration of CSF hypocretin-1 in patients with narcolepsy without cataplexy. Most neuroimaging studies to date have been conducted in small samples, while narcolepsy type 2 (or narcolepsy without cataplexy) and idiopathic hypersomnia remain relatively understudied. Almost all patients (87%) still complained of daytime sleepiness independent of hypocretin status.Conclusion: How is cataplexy without narcolepsy treated Treatment for cataplexy depends on how often your episodes happen and how severe they are. Of the 127 patients we were able to recontact, survival analysis showed that almost half (48%) with low concentration of CSF hypocretin-1 had developed typical cataplexy at 26 yr after onset, whereas only 2% had done so when CSF hypocretin-1 concentration was normal. Patients with intermediate concentrations of CSF hypocretin-1 (n = 13, 8%) had intermediate HLA DQB1*06:02 and polysomnography results, suggesting heterogeneity. They also had more frequently short rapid-eye movement (REM) sleep latency (≤ 15 min) during polysomnography (64% versus 23%), and shorter sleep latencies (2.7 ± 0.3 versus 4.4 ± 0.2 min) and more sleep-onset REM periods (3.6 ± 0.1 versus 2.9 ± 0.1 min) during the Multiple Sleep Latency Test (MSLT). Compared with patients with normal hypocretin-1 concentration (n = 117, 68%), those with low hypocretin-1 concentration had higher HLA DQB1*06:02 frequencies, were more frequently non-Caucasians (notably African Americans), with lower age of onset, and longer duration of illness. Patients with low concentrations of hypocretin-1 only differed subjectively from other groups by a higher Epworth Sleepiness Scale score and more frequent sleep paralysis. Forty-one patients (24%), all HLA DQB1*06:02 positive, had low concentrations (≤ 110 pg/ml) of CSF hypocretin-1. 2 The most well-known symptom of narcolepsy is excessive sleepiness that causes you to fall asleep without. The optimal cutoff of CSF hypocretin-1 for narcolepsy without cataplexy diagnosis was 200 pg/ml rather than 110 pg/ml (sensitivity 33%, specificity 99%). Narcolepsy isn’t very common about 1 in every 2,000 people are estimated to have it. Learn more about their causes, symptoms, and treatments here. Patients were also recontacted to evaluate if they developed cataplexy by survival curve analysis.Measurements and Results: There are two main types of narcolepsy: type 1, with cataplexy, and type 2, without cataplexy. Retrospective comparison and receiver operating characteristics curve analysis. Narcolepsy without cataplexy (n = 171) and control patients (n = 170), all with available CSF hypocretin-1.Design and interventions: University-based sleep clinics and laboratories.Patients: To compare clinical, electrophysiologic, and biologic data in narcolepsy without cataplexy with low (≤ 110 pg/ml), intermediate (110–200 pg/ml), and normal (> 200 pg/ml) concentrations of cerebrospinal fluid (CSF) hypocretin-1.Setting: ![]()
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