Summary
Objective
The aim is to create a matrix of relevant information about narcolepsy in Germany for a narcolepsy register.
Method
A retrospective study of randomly selected hospital records of 106 narcoleptic patients, all presenting cataplexies and excessive daytime sleepiness plus HLA DR 2 positive typing, was performed.
Results
First symptoms of narcolepsy evolved mainly between the ages 10–20 and 30–45. In patients with early manifestation the latency between onset of excessive daytime sleepiness and cataplexy was much longer than in those with late manifestation (19.4 vs 7.9 years, p<0.001). Since the chance of narcolepsy to be diagnosed increases significantly after the onset of cataplexies the latency between manifestation of first symptoms and diagnosis is much shorter in the group with later manifestation. Women showed a slightly earlier manifestation (22.0 years) than men (23.7 years).
Conclusion
Our findings may implicate the existence of two different types of narcolepsy, depending on the age of manifestation of first symptoms.
Zusammenfassung
Einführung
Ziel ist die Erstellung einer Matrix relevanter Daten von Narkolepsiepatienten für ein deutsches Narkolepsieregister.
Methode
In einer retrospektiven Untersuchung zufällig ausgewählter Krankenakten wurden Daten von 106 Patienten mit Kataplexien, Tagesschläfrigkeit und positiver HLA-DR-2 Typisierung erfaßt.
Ergebnisse
Erste Narkolepsiesymptome entwickeln sich meist im Alter zwischen 10–20 und 30–45. Bei Patienten mit früher Symptommanifestation war die Latenz zwischen dem Auftreten von Tagesschläfrigkeit und Kataplexien viel länger als bei Patienten mit einer späten Symptommanifestation (19,4 vs 7,9 Jahre, p<0,001). Da die Diagnose signifikant häufiger gestellt wird, wenn Kataplexien auftauchen, als wenn Tagesschläfrigkeit als einziges Hauptsymptom vorhanden ist, ist die Latenz vom Auftreten erster Symptome bis zur Diagnosestellung bei der Gruppe mit später Erstmanifestation sehr viel kürzer als bei früher Symptommanifestation. Bei Frauen scheinen sich erste Symptome etwas früher zu manifestieren (22,0 Jahre) als bei Männern (23,7 Jahre).
Schlussfolgerung
Unsere Befunde legen die Existenz von zwei unterschiedlichen Formen der Narkolepsie nahe, die altersabhängig sind.
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Mayer, G., Kesper, K., Peter, H. et al. The implications of gender and age at onset of first symptoms in narcoleptic patients in Germany—results from retrospective evaluation of hospital records. Somnologie 6, 13–18 (2002). https://doi.org/10.1046/j.1439-054x.2002.02005.x
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DOI: https://doi.org/10.1046/j.1439-054x.2002.02005.x