Progressive narcolepsy: how to deal with intermediate hypocretin-1 values?

Unlabelled: According to the , third edition guidelines, the diagnosis of narcolepsy type 1 is based on the association of excessive daytime sleepiness plus either cataplexy and electrophysiological criteria, or a cerebrospinal fluid hypocretin-1 concentration below 110 pg/mL. This threshold remains debated, and recent works have proposed alternative values in the intermediate (110 to 200 pg/mL) zone. We report the case of a patient who presented with typical clinical symptoms of narcolepsy type 1 developing over six years but in whom initial polysomnography and multiple sleep latency test were negative and cerebrospinal fluid hypocretin-1 was intermediate (132 pg/mL).

Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia.

Study Objectives: First, to determine whether the 3-item Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) measures the degree of excessive daytime sleepiness in patients with suspected narcolepsy or idiopathic hypersomnia (IH). Second, to assess the correlation between the ODSI and the Epworth Sleepiness Scale (ESS) as well as objective polysomnographic measurements. Third, to test the accuracy of the ODSI to detect narcolepsy or IH (narcolepsy/IH) compared with the ESS.

Impaired sleep-associated modulation of post-exercise corticomotor depression in multiple sclerosis.

Objective: To compare the beneficial effect of nap versus rest on the recovery of motor evoked potentials (MEPs) after a fatiguing exercise performed in patients with multiple sclerosis (MS) and healthy controls.

Methods: In 12 MS patients and 12 healthy controls, MEPs were recorded from the adductor pollicis muscle before, 10 and 60 min (T0, T10, and T60) after an effort of thumb adduction at 25% of maximal voluntary contraction force for 24 min. After the effort, the subject was maintained at rest or invited to have a nap while monitored with polysomnography.

Bilateral thalamic stimulation induces insomnia in patients treated for intractable tremor.

Study Objectives: To explore the influence of acute bilateral ventral intermediate thalamic nucleus (VIM) stimulation on sleep.

Design: Three consecutive full-night polysomnography recordings were made in the laboratory. After the habituation night, a random order for night ON-stim and OFF-stim was applied for the second and third nights.

Sleep continuity: a new metric to quantify disrupted hypnograms in non-sedated intensive care unit patients.

Introduction: Sleep in intensive care unit (ICU) patients is severely altered. In a large proportion of critically ill patients, conventional sleep electroencephalogram (EEG) patterns are replaced by atypical sleep. On the other hand, some non-sedated patients can display usual sleep EEG patterns.

Ventricular orexin-A (hypocretin-1) levels correlate with rapid-eye-movement sleep without atonia in Parkinson's disease.

Objective: Patients with Parkinson's disease frequently complain of sleep disturbances and loss of muscle atonia during rapid-eye-movement (REM) sleep is not rare. The orexin-A (hypocretin-1) hypothalamic system plays a central role in controlling REM sleep. Loss of orexin neurons results in narcolepsy-cataplexy, a condition characterized by diurnal sleepiness and REM sleep without atonia.