脱失眠:反射失眠的罕见原因之一
Otto Fenske1, John P Foran2, Salma Nowell3
1Undergraduate Education Department, Epsom and Saint Helier University Hospitals NHS Trust, London, UK otto.fenske@nhs.net.
BMJ case reports
|November 10, 2025
概括
一名年轻女子被诊断患有脱失眠,这是一种罕见的疾病,在吃饭时会导致昏. 用心脏起器治疗有效地解决了她的症状,强调了及时诊断和干预的重要性.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 胃肠病学 胃肠病学
背景情况:
- 消性昏迷是一种罕见的疾病,其特征是吞引发的昏迷.
- 它通常与显著的阴道反应相关,导致心脏抑制.
- 这一案例突显了一个年轻患者的长期诊断旅程,患有非典型症状.
研究的目的:
- 在一个年轻的女性中呈现一种罕见的脱失眠病例.
- 为了说明诊断挑战和成功管理这种情况.
- 讨论潜在的治疗选择,包括心脏起器植入和心脏神经衰竭.
主要方法:
- 详细的病史,包括10年前和视力障碍的病史.
- 诊断调查包括休息12导电图和门诊霍尔特监测.
- 在吃饭时进行挑性测试,对静脉注射氨酸的反应,以及排除胃肠道病理.
主要成果:
- 患者在吃饭时经历了可重复的,高度的心房门 (AV) 阻塞与心室缩.
- 通过静脉注射氨酸消除了症状,证实了阴道介导的过程.
- 双室心脏起器植入导致症状完全消失.
结论:
- 脱失眠需要彻底的病史和诊断评估,包括挑性测试.
- 阴道功能障碍是一个关键的机制,对抗胆固醇药物和节拍反应.
- 心脏起器植入为耐火病例提供了明确的治疗方法,改善了生活质量.
相关概念视频
Hypoglycemia and Glucagon
787
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
787
Deglutition
5.2K
Swallowing, otherwise known as deglutition, facilitates the transport of food from the mouth to the stomach. It is a multifaceted process that involves both the tongue and the muscles of the throat and esophagus. Saliva and mucus aid in this process, which takes approximately 4 to 8 seconds for semi-solid or solid food and around 1 second for liquids or very soft food.
Swallowing can be divided into three stages: the voluntary phase, the pharyngeal phase, and the esophageal phase. Although the...
Swallowing can be divided into three stages: the voluntary phase, the pharyngeal phase, and the esophageal phase. Although the...
5.2K
Disorders of the Autonomic Nervous System
1.4K
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's...
Raynaud's disease, also known as Raynaud's...
1.4K
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
1.3K
Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
1.3K
Sleepwalking and Sleep Talking
816
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...
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
816
Narcolepsy
475
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.
475


