Objective measure of hypocretin deficiency in the cerebrospinal fluid (CSF) as defined by “less than or equal to 110 pg/mL”, excluding CSF levels of hypocretin-1 in the context of recent TBI. In children or in individuals “within six months of narcolepsy onset, involuntary grimacing or jaw-opening with tongue thrusting, or hypotonia”, in the absence of clear emotional triggers.3. Episodes of cataplexy, or loss of muscle tonus, occurring several times a month, episodes lasting seconds to minutes of sudden full body loss of skeletal muscle tone without LOC (Loss Of Consciousness) that are precipitated by an episode of strong emotion. These episodes must occur at least three times per week over the past three months, accompanied by at least one of the following symptoms:ġ. Symptoms of NarcolepsyĪccording to the DSM-5, (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), narcolepsy is a disorder in which the individual will experience recurrent periods of an irresistible need to sleep, or will fall asleep, or nap within the same day, regardless of whether or not the time and place are appropriate. Hypnogogic hallucinations (vivid dreams upon onset of sleep) hypnopompic hallucination (vivid dreams upon waking) and sleep paralysis (inability to move upon waking) can be part of the clinical presentation (Simon, 2012). Their should be an objective laboratory finding of abnormally low levels of hypocretin, a neuropeptide associated with sleep/wake and arousal levels, (Tsujino & Sakurai, 2009), and according to a polysomnography study, unusually low amounts of REM sleep during nocturnal sleep. The sleep episodes will typically be triggered by a strong emotional response in the individual (Psychologist world, 2014), or a heavy meal, or general psychosocial stressors (Simon, 2012). Narcolepsy is accompanied by unusually rapid onset of REM sleep (American Psychiatric Association, 2013). Despite adequate nocturnal sleep, the individual will experience daytime fatigue, or EDS (Excessive Daytime Sleepiness) (Psychologist World, 2014), and (University of Tennessee, 2014).The individual will experience sudden loss of muscle tonus ranging from isolated muscle weakness to bilateral, full body loss of muscle tonus, and will fall asleep in inappropriate times and places, which may place themselves or others in danger, if they are driving or doing another potentially hazardous activity. Narcolepsy is a neurologically based, chronic, hypersomnic type of sleep disorder, which typically appears in childhood, adolescence or young adulthood. DSM-5 Category: Sleep-Wake Disorders Introduction
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