Two cases of childhood narcolepsy mimicking epileptic seizures in video-EEG/EMG

被引:5
|
作者
Yanagishita, Tomoe [1 ]
Ito, Susumu [1 ]
Ohtani, Yui [1 ]
Eto, Kaoru [1 ]
Kanbayashi, Takashi [2 ]
Oguni, Hirokazu [1 ]
Nagata, Satoru [1 ]
机构
[1] Tokyo Womens Med Univ, Dept Pediat, Tokyo, Japan
[2] Akita Univ, Dept Neuropsychiat, Sch Med, Akita, Japan
来源
BRAIN & DEVELOPMENT | 2018年 / 40卷 / 10期
关键词
Narcolepsy; Cataplexy; Clonic seizures; Myoclonic seizures; Electroencephalography; Electromyography; Video-polygraph;
D O I
10.1016/j.braindev.2018.05.015
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Narcolepsy is characterized by excessive sleepiness, hypnagogic hallucinations, and sleep paralysis, and can occur with or without cataplexy. Here, we report two children with narcolepsy presenting with cataplexy mimicking epileptic seizures as determined by long-term video-electroencephalography (EEG) and electromyography (EMG) monitoring. Case 1 was a 15-year-old girl presenting with recurrent episodes of "convulsions" and loss of consciousness, who was referred to our hospital with a diagnosis of epilepsy showing "convulsions" and "complex partial seizures". The long-term video-polygraph showed a clonic attack lasting for 15 s, which corresponded to 1-2 Hz with interruption of mentalis EMG discharges lasting for 70-300 ms without any EEG changes. Narcolepsy was suspected due to the attack induced by hearty laughs and the presence of sleep attacks, and confirmed by low orexin levels in cerebrospinal fluid (CSF). Case 2 was an 11-year-old girl presenting with recurrent episodes of myoclonic attacks simultaneously with dropping objects immediately after hearty laughs, in addition to sleep attacks, hypnagogic hallucinations, and sleep paralysis. The long-term video-polygraph showed a subtle attack, characterized by dropping chopsticks from her hand, which corresponded to an interruption of ongoing deltoid EMG discharges lasting 140 ms without any EEG changes. A diagnosis of narcolepsy was confirmed by the low orexin levels in CSF. These cases demonstrate that children with narcolepsy may have attacks of cataplexy that resemble clonic or myoclonic seizures. (C) 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:939 / 942
页数:4
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