Cases reported "Narcolepsy"

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1/8. hallucinations, REM sleep, and Parkinson's disease: a medical hypothesis.

    BACKGROUND: patients with PD can have disabling visual hallucinations associated with dopaminergic therapy. sleep disorders, including vivid dreams and REM sleep with motor behaviors (RBD), are frequent in these patients. methods: The association of hallucinations and REM sleep both at night and during the day was examined in 10 consecutive nondemented patients with long-standing levodopa-responsive PD and hallucinations. Seven patients presented with paranoia and paranoid delusions. Overnight sleep recordings and standard multiple daytime sleep latency test were performed. The results were compared to those of 10 similar patients with PD not experiencing hallucinations. RESULTS: RBD was detected in all 10 patients with hallucinations and in six without. Although nighttime sleep conditions were similar in both groups, hallucinators tended to be sleepier during the day. delusions following nighttime REM period and daytime REM onsets were observed in three and eight of the hallucinators, and zero and two of the others. Daytime hallucinations, coincident with REM sleep intrusions during periods of wakefulness, were reported only by hallucinators. Postmortem examination of the brain of one patient showed numerous lewy bodies in neurons of the subcoeruleus nucleus, a region that is involved in REM sleep control. CONCLUSION: The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery. Psychosis in patients with PD may therefore reflect a narcolepsy-like REM sleep disorder.
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ranking = 1
keywords = paranoid
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2/8. Misleading hallucinations in unrecognized narcolepsy.

    OBJECTIVE: To describe psychosis-like hallucinatory states in unrecognized narcolepsy. METHOD: Two patients with hypnagogic/hypnapompic hallucinations are presented. RESULTS: Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy. CONCLUSION: We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.
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ranking = 0.046324030879325
keywords = psychosis
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3/8. schizophrenia and narcolepsy: a review with a case report.

    Several reports emphasize the importance of differentiating between psychosis in schizophrenia and the psychotic form of narcolepsy. The failure to identify narcolepsy leads to the labeling of patients as refractory to standard treatments for schizophrenia and retards consideration of intervention for narcolepsy in which psychosis can improve with psychostimulant treatment. Psychosis in patients with narcolepsy can occur in three ways: (i) as the psychotic form of narcolepsy with hypnagogic and hypnopompic hallucinations; (ii) as a result of psychostimulant use in a patient with narcolepsy; and (iii) as the concurrent psychosis of schizophrenia in a patient with narcolepsy. The present case report describes a difficult-to-treat patient who likely had concurrent schizophrenia and narcolepsy. It then summarizes the literature related to the treatment of the three types of patients with psychosis associated with narcolepsy.
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ranking = 0.1852961235173
keywords = psychosis
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4/8. Is schizophrenia associated with narcolepsy?

    OBJECTIVE: To determine the nature of the relationship between schizophrenia-like psychosis and narcolepsy. BACKGROUND: A relationship between schizophrenia and narcolepsy has long been postulated due to the association of schizophrenia-like psychosis with narcolepsy and its treatment. METHOD: We report two patients who presented with schizophrenia-like psychosis of narcolepsy and review the literature regarding possible shared neurobiology between the two disorders that might explain their co-occurrence. RESULTS: There appears to be little in the way of common pathology between these two conditions when symptoms, human leukocyte antigen associations, rapid eye movement sleep architecture, D2-dopamine receptor changes, and hypocretinergic function are examined. CONCLUSIONS: The available literature suggests that schizophrenia-like psychosis in narcolepsy is most commonly medication related or a chance co-occurrence, with limited evidence for a separate psychosis of narcolepsy.
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ranking = 0.23162015439662
keywords = psychosis
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5/8. narcolepsy, paranoid psychosis, and analeptic abuse.

    Analeptic-induced paranoid psychosis occasionally occurs in the treatment of narcolepsy. Two cases illustrate how analeptic abuse can contribute to the development of paranoid psychosis in narcolepsy and greatly complicate treatment.
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ranking = 90.579443496543
keywords = paranoid psychosis, paranoid, psychosis
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6/8. Pharmacologic and psychotherapeutic issues in coexistent paranoid schizophrenia and narcolepsy: case report.

    The case of a 32-year-old man with schizophrenia and narcolepsy, two seemingly unrelated disorders, is discussed from the perspective of the diagnostic and therapeutic challenges raised by their coexistence. In addition, the development of tardive dyskinesia and its subsequent amelioration with a depot form of a high-potency neuroleptic are discussed in relation to these disorders. Consistent and supportive psychotherapy for such patients is recommended for maintaining compliance, for pharmacotherapy, and an optimal level of personal, occupational, and interpersonal functioning.
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ranking = 4
keywords = paranoid
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7/8. narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia.

    This report describes a man with narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia. The case illustrates the treatment difficulties such a patient presents and also raises questions about interactions between the putative neurotransmitters involved in each of these conditions. It is suggested that the presence of narcolepsy may facilitate the appearance of unwanted effects of antidepressants and neuroleptics such as psychosis and depression.
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ranking = 75.529193611332
keywords = paranoid psychosis, paranoid, psychosis
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8/8. narcolepsy, paranoid psychosis, and tardive dyskinesia: a pharmacological dilemma.

    The case history of a 54-year-old man with concomitant narcolepsy, paranoid psychosis, and tardive dyskinesia is presented. These disorders may all result from alteration in catecholamines, serotonin, and/or acetylcholine in the central nervous system. The interactions of the various psychopharmacological agents usually used to treat the disorders when they occur separately are considered in terms of current neurotransmitter hypotheses. The management of this case creates a pharmacological dilemma; the agents used for treatment of each of the disorders separately exacerbate one or both of the other two syndromes.
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ranking = 75.482869580452
keywords = paranoid psychosis, paranoid, psychosis
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