Segregation of HLA genes in multicase narcolepsy families.

In the past 15 years, 411 sporadic narcolepsy patients have been diagnosed in the Hephata Klinik, Schwalmstadt, Germany. They were explored for presence or absence of excessive daytime sleepiness and narcolepsy in their relatives. A subset of 39 patients were explored for presence or absence of parasomnias.

[Sleep deprivation in somnambulism. Effect of arousal, deep sleep and sleep stage changes].

Diagnosis of parasomnias in the sleep laboratory is difficult since the nocturnal behavior reported by the patients often does not show up in the laboratory. To test the efficacy of sleep deprivation as a tool to provoke somnambulism we investigated ten patients (three women and seven men, mean age 27 +/- 3.4) with somnambulism.

Endocrinological and polysomnographic findings in Kleine-Levin syndrome: no evidence for hypothalamic and circadian dysfunction.

Five subjects--four men, ages 17-28, and one woman, age 30--with Kleine-Levin syndrome were investigated during symptomatic (SP) and asymptomatic (ASP) periods. Investigations comprised medical history, MRI, polysomnography, 24-hour hormone profile of human growth hormone, melatonin, TSH, cortisol and FSH (in the woman only) assessed every 2 hours, actimetry, and sleep logs. Medical history confirmed presence of the three symptoms diagnostic of of typical Kleine-Levin syndrome: hypersomnia, excessive food intake, and psychic alteration.

Circadian temperature and activity rhythms in unmedicated narcoleptic patients.

Fifteen unmedicated narcoleptic patients with and without sleep-onset REM period (SOREMP) were compared with 16 unmedicated, age-and-sex-matched control subjects with respect to polygraphic, core body temperature and motor activity recordings. Whereas narcoleptic patients with SOREMPs had significantly more quiet wakefulness during sleep, those without SOREMPs had significantly more quiet wakefulness during daytime than the other groups. Compared with that of controls, temperature of both narcoleptic groups showed (a) less rise of temperature curve in the morning, (b) dampening of temperature amplitude, (c) phase advance of acrophase, and (d) advance of temperature minimum after sleep onset.

[Differential diagnosis of seizures in sleep].

Epilepsies and the NREM and REM parasomnias represent the most important sleep-related attacks that can occur in conjunction with sleep apnoea. Most sleep-related attacks arise from certain sleep stages only, which facilitates their identification. Many attacks can only be classified by thorough observation and description, since they lack special electrophysiological correlates.