2010•Unpublished venueRequires access
Diretrizes brasileiras para o diagnóstico da narcolepsia Brazilian guidelines for the diagnosis of narcolepsy
Flávio Alóe, Rosana Cardoso Alves, John Fontenele Araújo, Alexandre Pinto de Azevedo, Andrea Bacelar, Márcio Luciano de Souza Bezerra, Lia Rita, A. C. R. Bittencourt, Guilherme Bustamante, Álan Luiz Éckeli, Regina M.F. Fernandes, Leonardo Ierardi Goulart, Marcia Lurdes de Cacia Pradella-Hallinan, Rosa Hasan, Heidi Haueisen Sander, Luciano Ribeiro Pinto, Maria Cecília Lopes, Gisele Richter Minhoto, Walter André dos Santos Moraes, Gustavo Antônio Moreira, Daniela Vianna Pachito, Dalva Rollemberg Poyares, Lucila Bizari Fernandes do Prado, Geraldo Nunes Vieira Rizzo, Raimundo Nonato Rodrigues, Israel Roitman, Ademir Baptista Silva, Stella Marcia Azevedo Tavares
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Abstract
This manuscript contains the conclusion of the consensus meeting on the diagnosis of narcolepsy based on the review of Medline publications between 1980-2010. Narcolepsy is a chronic disorder with age at onset between the first and second decade of life. Essential narcolepsy symptoms are cataplexy and excessive sleepiness. Cataplexy is defined as sudden, recurrent and reversible attacks of muscle weakness triggered by emotions. Accessory narcolepsy symptoms are hypnagogic hallucinations, sleep paralysis and nocturnal fragmented sleep. The clinical diagnosis according to the International Classification of Sleep Disorders is the presence of excessive sleepiness and cataplexy. A full in-lab polysomnography followed by a multiple sleep latency test is recommended for the confirmation of the diagnosis and co-morbidities. The presence of two sleep-onset REM period naps in the multiple sleep latency test is diagnostic for cataplexy-free narcolepsy. A positive HLA-DQB1*0602 with lower than 110pg/mL level of hypocretin-1 in the cerebrospinal fluid is required for the final diagnosis of cataplexy- and sleep-onset REM period -free narcolepsy.