Avaliação Do Sleep Onset Rapid Eye Movement Period (Soremp) Noturno No Diagnóstico De Narcolepsia De Pacientes Com Sonolência Excessiva Diurna Do Ambulatório De Narcolepsia Da Universidade Federal De São Paulo / Escola Paulista De Medicina
Objectives: The primary objective was to evaluate the nocturnal sleep onset rapid eye movement period (nSOREMP) prevalence in narcoleptics type 1 (NT1) and type 2 (NT2) patients. The secondary objective was to evaluate the diagnostic sensitivity and specificity of non-invasive, clinics and electroph...
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| Tipo de recurso: | tesis de maestría |
| Estado: | Versión publicada |
| Fecha de publicación: | 2017 |
| País: | Brasil |
| Institución: | Universidade Federal de São Paulo (UNIFESP) |
| Repositorio: | Repositório Institucional da UNIFESP |
| Idioma: | portugués |
| OAI Identifier: | oai:repositorio.unifesp.br:11600/50432 |
| Acceso en línea: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5078147 http://repositorio.unifesp.br/handle/11600/50432 |
| Access Level: | acceso abierto |
| Palabra clave: | Hla-Dqb1*0602 Sono Narcolepsia Hipocretina- Cataplexia Hla-Dqb1*060 |
| Sumario: | Objectives: The primary objective was to evaluate the nocturnal sleep onset rapid eye movement period (nSOREMP) prevalence in narcoleptics type 1 (NT1) and type 2 (NT2) patients. The secondary objective was to evaluate the diagnostic sensitivity and specificity of non-invasive, clinics and electrophysiological, methods as predictors of cerebrospinal fluid Hypocretin-1 (CSF Hcrt-1) deficiency in a population of patients with narcolepsy diagnosis (by ICSD-3 criteria) attended at excessive daytime sleepiness outpatient clinic of Universidade Federal de São Paulo / Escola Paulista de Medicina in the period from 2011 to 2016. Methods: In a retrospective analysis of medical records, patients were distributed in tow groups, according the ICSD-3 criteria (NT1 and NT2), for nSOREMP prevalence estimation (ou rate). Subsequently the patients were divided into 5 groups to evaluate the association with CSF Hcrt-1 deficiency (Group 1 – CSF Hcrt-1 level; Group 2 – cataplexy presence; Group 3 – nSOREMP presence; Group 4 - HLA-DQB1*0602 presence; Group 5 – cataplexy plus HLADQB1*0602 presence). Results: A total of ninety-one patients were included, of which 34 (37.36%) were male, average age of 35,2 ± 14,6 years. The nocturnal SOREMP was more prevalent in NT1 patients (35%) than in NT2 patients (7.5%); p<0,001. Among the noninvasive methods studied, the presence of HLA-DQB1*0602 allele was the best predictor of Hcrt-1 deficiency. Conclusions: The nocturnal SOREMP was more prevalent in NT1 patients. As an alternative for predicting CSF Hcrt-1 deficiency, the presence of cataplexy associated with HLA-DQB1*0602 allele was the best noninvasive method studied. When considering the requirement for an invasive procedure to obtain CSF and technical and methodological difficulty to perform the CSF Hcrt-1 measure, these non-invasive and non-lab methods could be more assessed. |
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