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Yıl:2013; Cilt: 16; Sayı: 4>> Özet
Klinik Psikiyatri Dergisi; 2013;16(4):244-248
Farklı Klinik Semptomlarla Ortaya Çıkan Narkolepsi Olguları
PG Özdemir, A Aydın, Y Selvi
100. Yıl Üniversitesi, Van
Narkolepsi, nadir görülen ve az tanınan ve atlanan bir durumdur. Aşırı gündüz uykululuğu, katapleksi, uyku paralizisi, hipnogojik ve hipnopompik varsanılarla karakterize bir bozukluktur. Gündüz aşırı uykululuğu narkolepsinin en önemli belirtisidir ve diğer psikiyatrik bozukluklarla karışabilir. Hastalığın katapleksi ile birlikte olan ve katapleksi ile birlikte olmayan şeklinde, birincil veya tıbbi duruma ikincil formları vardır. Çevresel ve genetik faktörlerin karmaşık bir etkileşimi neticesinde ortaya çıktığı düşünülmektedir. Narkolepsi tanısı klinik olarak konmaktadır. Bununla birlikte son zamanlarda narkolepsi tanısında uyku bozuklukları tıbbı alanında önemli gelişmeler olmuştur. Stimülanlar, modafinil ve antidepresanlar narkolepside tedavide kullanılan ilaçlardır. Narkolepsinin farklı klinik belirtileri diğer psikiyatrik hastalıklarla örtüşebilir. Bu yazıda iki olgu sunumu yapılmıştır. İlk olgu, klinik belirtileri açısından epilepsi tanısını düşündüren, antiepileptik tedavi başlanan ancak tedaviden yanıt alınamayan, ayrıntılı incelemelerle narkolepsi tanısı konduktan sonra başarılı şekilde tedavi edilen bir olgudur. İkincisi ise depresif semptomlarla başlayan ve depersonalizasyon, derealizasyon semptomları olup antidepresan tedaviden fayda görmeyen bir olgudur. Hasta narkolepsi tanısı konulduktan sonra stimülan ajanlarla başarılı bir şekilde tedavi edilmiştir. Narkolepsi belirtilerini tanıma ve farkındalık, bu hastalığa uygun zamanda tanı konmasını ve uygun tedavinin uygulanmasını sağlar. Dolayısıyla, klinisyenler narkolepsinin farklı klinik görünümleri konusunda dikkatli olmalıdırlar.
Narcolepsy Cases with Different Clinical Symptoms
Narcolepsy is an uncommon disorder and it is an underrecognized and underdiagnosed condition. It is characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic, and hypnopompic hallucinations. Excessive daytime sleepiness is the most important symptom and misdiagnoses other mental disorders. There are different groups of patients, those having narcolepsy with cataplexy and those having narcolepsy without cataplexy that can be primary or secondary due to medical condition. Narcolepsy is considered to be caused by a complex interaction of genetic and environmental factors. The diagnosis of narcolepsy is based primarily on clinical picture. On the other hand, recent years important developments occur in the sleep disorders medicine for narcolepsy. Stimulants, modafinil and antidepressants are the pharmacological agents used in narcolepsy for treatment. Different clinical symptoms of narcolepsy may overlap with other mental illnesses. In this article, we introduced two case reports. Our first case was clinically resembling epilepsy and it was non - responsive to antiepileptic treatment. The patient was diagnosed as narcolepsy after detailed investigations than treated successfully. And second one was manifested itself by depressive symptoms, depersonalization and derealization and non-responsive to antidepressant treatment. He was subjected to further investigation tests and he was treated with stimulants perfectly after the diagnosis of narcolepsy. The awareness of narcolepsy is important so that these cases could be identified timely and appropriately managed. Thus, clinicians should be careful about the different clinical characteristics of narcolepsy.

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