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Related Concept Videos

Narcolepsy01:07

Narcolepsy

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Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
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Seizures: Classification01:13

Seizures: Classification

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
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Sleep-Wake Cycles01:24

Sleep-Wake Cycles

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Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and  rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
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Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

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REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
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Sleepwalking and Sleep Talking01:17

Sleepwalking and Sleep Talking

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Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
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Manipulation of Epileptiform Electrocorticograms ECoGs and Sleep in Rats and Mice by Acupuncture
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Psychogenic Seizure Imitating Narcolepsy.

Galina M Diukova1, Sergey A Makarov2, Valery L Golubev2

  • 1Neurological Department, Moscow Clinical Research Center, Moscow, Russian Federation.

Case Reports in Neurology
|January 14, 2021
PubMed
Summary

Functional neurological disorders (FND), including psychogenic non-epileptic seizures (PNES), present diagnostic challenges. This case highlights PNES mimicking narcolepsy, with symptoms improving after disability benefit, suggesting a psychogenic component.

Keywords:
Functional neurological disordersPseudonarcolepsyPsychogenic non-epileptic seizures

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Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Functional neurological disorders (FND) are common in neurology practice, posing diagnostic difficulties.
  • Psychogenic non-epileptic seizures (PNES) constitute approximately 40% of FND cases.
  • Differentiating PNES from other conditions like narcolepsy is clinically significant.

Observation:

  • A 55-year-old man presented with frequent, brief, sleep-like attacks and nocturnal disturbances.
  • Attacks involved unresponsiveness, snoring, maintained posture, resisted eye opening, and post-attack confusion.
  • Interictal FND signs included give-way weakness, functional gait disturbance, and impaired finger-to-nose testing.

Findings:

  • Video-electroencephalogram (VEEG) monitoring revealed no epileptic activity or specific sleep patterns during attacks.
  • Polysomnography (PSG) and multiple sleep latency test (MSLT) excluded narcolepsy.
  • PNES presentation evolved, becoming less pronounced after the patient received disability benefits.

Implications:

  • This case underscores the diagnostic complexity of PNES, particularly when mimicking sleep disorders like narcolepsy.
  • The observed changes in PNES symptoms following disability benefit suggest a significant psychogenic influence.
  • Recognition of FND and PNES is crucial for accurate diagnosis and appropriate patient management.