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Hypersomnia

Hypersomnias


Presentation

  • We report a patient with polysomnography findings related to hypersomnia, as a primary presenting symptom, who was shown to have stereotypical gelastic seizures.[ncbi.nlm.nih.gov]
  • This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well.[ncbi.nlm.nih.gov]
  • Three patients with HSA and mandibular retrognathism are presented. Each patient had a retrognathic mandible that stemmed from a different cause. Surgical advancement of their underdeveloped mandibles corrected the symptoms of HSA rapidly.[ncbi.nlm.nih.gov]
  • In spite of these features similar to narcolepsy, these cases of REM hypersomnia did not present cataplexy or other auxiliary symptoms of narcolepsy, and, furthermore, the class-II human leukocyte antigen DR2 appeared to be negative.[ncbi.nlm.nih.gov]
  • The present result suggests also that RH involves dysfunction of the brain stem.[ncbi.nlm.nih.gov]
Hypersomnia
  • This review details most of those disorders, including narcolepsy with and without cataplexy, idiopathic hypersomnia with and without long sleep time, recurrent hypersomnia, behaviorally induced insufficient sleep syndrome, hypersomnia due to medical[ncbi.nlm.nih.gov]
  • BACKGROUND: Hypersomnia in inter-episode bipolar disorder has been minimally researched.[ncbi.nlm.nih.gov]
  • Convert to ICD-10-CM : 780.54 converts approximately to: 2015/16 ICD-10-CM G47.10 Hypersomnia, unspecified Approximate Synonyms Daytime hypersomnia Hypersomnia Hypersomnia (excessive sleeping) Hypersomnia, daytime Hypersomnia, idiopathic Idiopathic hypersomnia[icd9data.com]
  • Let's Get #BeyondSleepy Welcome to the Hypersomnia Foundation, committed to improving the lives of people living with idiopathic hypersomnia (IH) and related sleep disorders.[hypersomniafoundation.org]
  • Using MSLT, 35 (18.8%) of 186 patients had objective hypersomnia that may have been due to a drug or substance.[ncbi.nlm.nih.gov]
Fatigue
  • The male patient's complaints as fatigue, decreased level of concentration, and highly increased demand of sleeping started at his age of 21 years. No abnormality was found at physical examination.[ncbi.nlm.nih.gov]
  • The only symptom is excessive fatigue. Secondary hypersomnia is due to other medical conditions. These can include sleep apnea, Parkinson’s disease, kidney failure, and chronic fatigue syndrome.[healthline.com]
  • Excessive daytime sleepiness (EDS) is much more than being fatigued or tired.[tuck.com]
  • Individuals who have situations or circumstances that make them fatigued during the day are most at risk for hypersomnia.[therecoveryvillage.com]
Varicella-Zoster Virus Infection
  • A variant of the Kleine-Levin syndrome precipitated by both Epstein-Barr and varicella-zoster virus infections. Biol Psychiatry . 1993 Mar 1. 33 (5):388-90. [Medline] . GALLINEK A.[emedicine.com]
  • A variant of the Kleine-Levin syndrome precipitated by both Epstein-Barr and varicella-zoster virus infections. Biol Psychiatry. 1993 Mar 1. 33 (5):388-90. [Medline]. GALLINEK A.[emedicine.com]
Kayser-Fleischer Ring
  • Kayser-Fleischer ring was not detectable. D-penicillamine (DPA) was introduced. At 8-10 months after the initiation of the therapy the patient's complaints gradually resolved.[ncbi.nlm.nih.gov]
Dysmenorrhea
  • PIP: A 16-year old girl who had undergone normal pubertal development at 13 years 8 months began to menstruate with moderate or severe dysmenorrhea and 1 to 2 weeks of hypersomnia at 16 years 2 months.[ncbi.nlm.nih.gov]

Workup

Intermittent Slow Activity
  • Electroencephalographic (EEG) background activity for this individual was slightly slowed in the EEG during an episode of hypersomnia, and intermittent slow activity was found in addition.[ncbi.nlm.nih.gov]
Gliosis
  • Severe neuronal loss and gliosis were observed in the midbrain and pontine raphe, particularly in dorsal raphe nucleus and superior central nucleus. Pontine and medullary reticular formation also showed a marked cell loss and fibrillary gliosis.[ncbi.nlm.nih.gov]
White Matter Lesions
  • A CT study found hyperostosis and corresponding microcephaly in 71% and ventriculomegaly in 13% of patients. 9 However, using MRI, ventriculomegaly was evident in 71%. 10 Studies with MRI are conflicting with respect to the presence of white matter lesions[jnnp.bmj.com]
HLA-DR1
  • Both patients share the same HLA haplotype (HLA-DR1, DQ1) which has been found in Kleine-Levin syndrome.[ncbi.nlm.nih.gov]

Treatment

  • Type and frequency of substance use were assessed at treatment entry. Substance use was also assessed 12 months following treatment completion.[ncbi.nlm.nih.gov]
  • As additional clinical features were identified and treatments were ruled ineffective, further diagnoses were proposed. The patient's symptoms ceased with oral contraceptive treatment.[ncbi.nlm.nih.gov]
  • Mean total sleep times after treatment were 9.1 0.7 and 8.5 1.0h at 4 and 8 treatment weeks, respectively. Mean ESS scores were 8.8 2.3 and 7.4 2.8 at 4 and 8 treatment weeks, respectively. One patient dropped out at the 2nd week due to poor effect.[ncbi.nlm.nih.gov]
  • There are no FDA-approved treatments, and off-label usage of narcolepsy treatments seldom provide benefit. Patients are largely left on their own to alleviate the compound effects of this disorder on their quality of life.[ncbi.nlm.nih.gov]
  • Articles were included if they were in English and included information regarding the epidemiology, diagnosis, pathophysiology, or treatment of IH or HD.[ncbi.nlm.nih.gov]

Prognosis

  • Referral to a sleep specialist is required in performing objective sleep studies, establishing the diagnosis, recommending treatment, and providing a prognosis. Many sleep disorders are treatable and aeromedically waiverable.[ncbi.nlm.nih.gov]
  • Prognosis Hypersomnia can be chronic, especially when not associated with another disorder and therefore can continue to worsen if left untreated. Treatments are readily available and can improve the prognosis significantly.[allpsych.com]
  • Prognosis The prognosis for persons with hypersomnia depends on the cause of the disorder. While the disorder itself is not life threatening, it can have serious consequences, such as automobile accidents caused by falling asleep while driving.[brainfacts.org]
  • What is the Prognosis of Idiopathic Hypersomnia? (Outcomes/Resolutions) The prognosis of Idiopathic Hypersomnia depends upon the severity of the symptoms.[dovemed.com]

Etiology

  • […] the etiology or severity of centrally mediated hypersomnia.[ncbi.nlm.nih.gov]
  • The possible etiological role of developmental structural brain anomalies and the differential diagnosis of recurrent hypersomnia and abnormal behavior in patients with pervasive developmental disorders are discussed.[ncbi.nlm.nih.gov]
  • We examined an obese 58-year-old patient with a bilateral posterior hypothalamic lesion of unknown etiology. A 24-hour polysomnography revealed a markedly increased total sleep time (17.6 h). During daytime, only 3 continuous wake phases occurred.[ncbi.nlm.nih.gov]
  • Chronic hypersomnia does not correspond to an individual clinical entity but includes numerous different etiologies of hypersomnia as recently reported in the revised International Classification of Sleep Disorders.[ncbi.nlm.nih.gov]
  • In both, the etiology remains unknown but autoinmune, hormonal, infectious, and inflammatory mechanisms have been proposed.[ncbi.nlm.nih.gov]

Epidemiology

  • Articles were included if they were in English and included information regarding the epidemiology, diagnosis, pathophysiology, or treatment of IH or HD.[ncbi.nlm.nih.gov]
  • Epidemiology of narcolepsy : development of the Ullanlinna Narcolepsy Scale / Christer Hublin -- 14. Epidemiology of narcolepsy / Maurice M. Ohayon -- 15.[worldcat.org]
  • METHODS: Data were drawn from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of the US adult population (wave 1, 2001-2002; wave 2, 2004-2005).[ncbi.nlm.nih.gov]
  • Counseling and Support, The University of Tokyo, Tokyo, Japan. 6 Department of Child and Adolescent Psychiatry, Hamamatsu University School of Medicine, Shizuoka, Japan. 7 Asunaro Hospital for Child and Adolescent Psychiatry, Mie, Japan. 8 Department of Epidemiology[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Articles were included if they were in English and included information regarding the epidemiology, diagnosis, pathophysiology, or treatment of IH or HD.[ncbi.nlm.nih.gov]
  • These findings may serve to better understand some clinical features of the pathophysiology in sleep - wake rhythms in IH.[ncbi.nlm.nih.gov]
  • This case may contribute to better understanding the possible pathophysiological mechanism for posttraumatic hypersomnia.[ncbi.nlm.nih.gov]
  • Abstract Most central disorders of hypersomnolence are conditions with poorly understood pathophysiologies, making their identification, treatment, and management challenging for sleep clinicians.[ncbi.nlm.nih.gov]
  • Canine narcolepsy : history and pathophysiology / Emmanuel Mignot -- 24. Vigilance tests in narcolepsy / Johannes Mathis and Christian W. Hess -- 25. Lessons from sleepy mice : narcolepsy-cataplexy and the orexin neuropeptide system / Jon T.[worldcat.org]

Prevention

  • Thus, this case suggests that vitamin B12 may be effective for preventing recurrent hypersomnia.[ncbi.nlm.nih.gov]
  • If all these treatments are not helpful then the last resort is surgery to prevent blockage of airways while sleeping.[epainassist.com]

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