The following are the answers given by medicine:
First, sleep attacks. Patients are usually at a low level of arousal, especially in the afternoon, especially after meals or in a warm environment. Each attack lasts for several seconds to several hours, usually more than ten minutes, and can be awakened. It can happen many times a day.
Second, suddenly fall down. About 70% patients can accompany them, especially when they are excited, such as laughter, anxiety and fear. Suddenly there is a short-term decrease in muscle tone and exercise inhibition, and you fall or kneel down. Lighter people can only be weak in limbs.
Third, sleep paralysis. About 20-30% patients have sleep paralysis attacks, which often occur after waking up or falling asleep. Although the patient is conscious, he is weak and unable to move all over. It usually takes several seconds to several minutes to recover.
Fourth, sleep hallucinations. About 30% patients have sleep hallucinations, which often occur when they fall asleep. There are all kinds of hallucinations and auditory hallucinations, most of which are very realistic, mostly unpleasant daily experiences, and may also be accompanied by sleep paralysis. Sleeping at night often has many dreams and is easy to wake up.
Diagnosis and differential diagnosis
According to the typical symptoms such as transient paroxysmal irresistible sleep or collapse, sleep paralysis and sleep hallucination, it is generally not difficult to diagnose. But it should be differentiated from the following diseases.
First, seizures. More common in children or adolescents, with disturbance of consciousness as the main symptom, often suddenly losing consciousness, staring, standing still and not falling down; Or suddenly stop the ongoing action, such as landing with an object, and can't continue the original action for a few seconds. The EEG may have a 3Hz spike-slow complex wave.
Second, faint. Transient loss of consciousness caused by cerebral blood circulation disorder. There are many short-term precursors such as dizziness, weakness, nausea, and blackness in front of your eyes, and then you lose consciousness and faint. Often accompanied by autonomic nervous symptoms, such as pallor, cold sweat, weak pulse and low blood pressure, lasting for several minutes.
Third, Klein-Levin syndrome. Also known as periodic sleepiness and pathological hunger syndrome. Usually seen in male adolescents, they have periodic attacks (several weeks or months apart), lasting for 3 ~ 10 days each time, showing drowsiness, overeating and abnormal behavior. The etiology and pathogenesis are still unclear, which may be caused by diencephalon dysfunction, especially hypothalamic dysfunction or focal encephalitis.
prognosis
Generally, the prognosis is good, and it can be relieved after many years. The disease itself does not directly cause serious consequences, but narcolepsy will affect study and work.
treat cordially
Such patients should not engage in dangerous work such as high altitude, underwater, driving and high-voltage electrical appliances to prevent accidents. Treatment can choose amphetamine 10 ~ 20 mg, ritalin 5 ~ 10~20mg, methylphenidate 2mg, sodium benzoate caffeine 1 ~ 3 g, 2 ~ 3 times a day. Patients with cataplexy can use imipramine 20 ~ 50mg and chlorhexidine 0.2～0.4g, 2 ~ 3 times a day. Try not to accept the above drugs after 4pm, so as not to affect their sleep at night.