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KMID : 0389520000070020115
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Sleep Medicine.Psychophysiology
2000 Volume.7 No. 2 p.115 ~ p.119
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Narcolepsy Variant Presented with Difficult Waking
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Lee Hyang-Woon
Hong Seung-Bong
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Abstract
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Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis.
Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out.
Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DO6-positive. that corresponded at the genomic level to the subregion DOB1*0601, which was different from the usual locus in narcolepsy patients (DOB1^(*)0602 and DOAl^(*)0102).
Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.
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KEYWORD
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Difficult waking, HLA DQ6, DQB1 0601, Clircadian rhythm disorder, Narcolepsy variant,
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