This week, our hypothetical patient is a 7-year-old girl whose parents brought her into the clinic because she has gained an unusual amount of weight and has been excessively tired during the day, which has caused her to frequently fall asleep at school. When she first wakes up from these episodes, she is unable to speak or move her arms or legs for several minutes. This, in addition to her reports of waking up in the middle of the night and frequently experiencing nightmares, has caused the patient to fear falling asleep.
Today, we reveal that our hypothetical patient was diagnosed as having:
Narcolepsy
This chronic neurodegenerative disease is relatively rare and can be challenging to diagnose, particularly in cases with patients that do not present with the classic symptoms of excessive daytime sleep and cataplexy. Misdiagnosis among children with narcolepsy can disrupt normal growth patterns and have life-threatening consequences. Narcolepsy is caused by autoimmune dysfunction that destroys neurons that produce hypocretin, a chemical in the brain that prevents REM sleep from occurring indiscriminately and sustains alertness. This disease is often diagnosed through physical examination, reviewing medical history, and conducting sleep studies. Children with narcolepsy usually have shortened average sleep latency on EEGs and sleep onset REM periods. These issues can be detected using video-EEGs, nocturnal polysomnography (PSG), and Multiple Sleep Latency Tests (MSLTs). Narcolepsy is typically treated with a combination of medications and behavioral modifications. Counseling is recommended, particularly for patients with trauma-triggered clinical manifestations of the disease. Changes to diet and sleep patterns as well as noticing, anticipating, and reducing triggers can help improve patient quality of life.
Thanks for joining us for this week's Mystery Case and we hope to see you next week!
To solve this problem as well as the drug addiction problem, the Low Dose Naltrexone (LDN) was brought into use. LOW DOSE NALTREXONE (LDN) , completely opposite from a high dose of Naltrexone, acted by blocking opioid receptors temporarily. As a result, the body increased the production of endorphins and enkephalins. The increased levels of these hormones helped relieve pain, inflammation and contribute to the overall well-being. All this was done without having any harmful effects on health, like higher naltrexone doses.
ReplyDelete