As compared with controls, patients with narcolepsy showed a statistically significant excess prevalence in all the CCS multilevel categories, the only exceptions being conditions originating in the perinatal period and pregnancy/childbirth complications. The final study group included 9312 subjects with narcolepsy and 46,559 controls (each group: average age, 46.1 years 59% female). Narcolepsy and control subjects were compared for frequency of comorbid conditions, identified by the appearance of >1 diagnosis code(s) mapped to a Clinical Classification System (CCS) level 1 category any time during the study period, and on specific subcategories, including recognized narcolepsy comorbidities of obstructive sleep apnea (OSA) and depression.
#A brain scan of narcolepsy cataplexy code#
Truven Health Analytics MarketScan® Research Databases were accessed to identify individuals ≥18 years of age with ≥1 diagnosis code for narcolepsy (International Classification of Diseases (ICD)-9, 347.0, 347.00, 347.01, 347.1, 347.10, or 347.11) continuously insured between 20, and controls without narcolepsy matched 5:1 on age, gender, region, and payer. This was a retrospective medical claims data analysis. The objective of this study was to evaluate medical comorbidity patterns in patients with a narcolepsy diagnosis in the United States. Medical comorbidity in narcolepsy: findings from the Burden of Narcolepsy Disease (BOND) study.īlack, J Reaven, N L Funk, S E McGaughey, K Ohayon, M M Guilleminault, C Ruoff, C on behalf of the American College of Veterinary Internal Medicine.
Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. These findings suggest that disruptions in downstream signaling of hypocretin secondary to an intracranial mass effect might result in narcolepsy-cataplexy in dogs and that brain MRI should be strongly considered in sporadic cases of narcolepsy-cataplexy. Nine months after SRT, the dog developed clinical hyperadrenocorticism, which was successfully managed with trilostane. The Dachshund underwent stereotactic radiotherapy (SRT), which resulted in reduction in the mass and coincident resolution of the cataplectic attacks. The dog was also negative for the hypocretin receptor 2 gene mutation associated with narcolepsy in Dachshunds, ruling out familial narcolepsy. Cerebral spinal fluid hypocretin-1 levels were normal, indicating that tumor effect on the ventral lateral nucleus of the hypothalamus was not the cause of the dog's narcolepsy-cataplexy. A 6-year-old male neutered Dachshund had presented for acute onset of feeding-induced cataplexy and was found to have a pituitary macrotumor on magnetic resonance imaging (MRI). In this report, a pituitary mass is described as a unique cause of narcolepsy-cataplexy in a dog. Schmid, S Hodshon, A Olin, S Pfeiffer, I Hecht, Sįamilial narcolepsy secondary to breed-specific mutations in the hypocretin receptor 2 gene and sporadic narcolepsy associated with hypocretin ligand deficiencies occur in dogs. Pituitary Macrotumor Causing Narcolepsy-Cataplexy in a Dachshund. In narcolepsy, there appears to be a reversal of normal cerebral deactivation patterns, particularly involving the brainstem, during stages I and II sleep.« less During stages I and II sleep without REM, there were significant increases in mean hemispheric Fg and brainstem-cerebellar Fg, just the opposite of changes in normals. During REMmore » sleep, mean hemispheric Fg increased concurrently with large increases in brainstem-cerebellar region flow. In patients with narcolepsy, mean hemispheric Fg while awake was 80.5 +- 13 ml per 100 gm brain per minute. Maximum regional blood flow decreases during sleep occurred in the brainstem-cerebellar, right inferior temporal, and bilateral frontal regions. In normals, mean hemispheric gray matter blood flow (Fg) during stages I and II sleep was significantly less than waking values. Electroencephalogram, electro-oculogram, and submental electromyogram were recorded simultaneously.
#A brain scan of narcolepsy cataplexy serial#
Serial measurements of regional cerebral blood flow were made by the 135Xe inhalation method during the early stages of sleep and wakefulness in eight normal volunteers and 12 patients with narcolepsy.
Narcolepsy: regional cerebral blood flow during sleep and wakefulnessĭOE Office of Scientific and Technical Information (OSTI.GOV)
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