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J Neurol Neurosurg Psychiatry. 2008 Nov;79(11):1262-7. doi: 10.1136/jnnp.2007.143420. Epub 2008 Apr 3.

Narcolepsy in Southern Chinese patients: clinical characteristics, HLA typing and seasonality of birth.

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  • 1Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Prince of Wales and Shatin Hospitals, Shatin, Hong Kong SAR. ykwing@cuhk.edu.hk

Abstract

OBJECTIVE:

To report clinical characteristics, human leukocyte antigen (HLA) typing and seasonality of birth of a series of 54 Southern Chinese patients suffering from narcolepsy.

METHODS:

All subjects underwent detailed medical and psychiatric interviews and a standardised nocturnal polysomnogram followed by a daytime Multiple Sleep Latency Test. Each subject also completed a set of sleep questionnaires. HLA typing was performed in 91% of subjects.

RESULTS:

A total of 78% and 22% of patients were diagnosed with suffering from cataplectic and non-cataplectic narcolepsy, respectively. The majority (n = 47, 87%) of patients were referred to our sleep clinic for excessive daytime sleepiness (EDS). The cataplectic narcolepsy differed from non-cataplectic narcolepsy by having more rapid eye movement (REM)-related clinical symptoms (more sleep paralysis and sleep-related hallucination) and sleep disturbances (shorter REM latency), as well as tighter association with HLA DQB1*0602. A bi-modal peak pattern was observed at 11 and 39 years old. A similar bi-modal pattern also occurred for EDS and cataplexy. Excess winter births were observed for this series of patients. 81% of patients with cataplectic narcolepsy were DQB1*0602-positive. There were no differences between early- and late-onset cases in the association with positive DQB1*0602 (71.4% vs 60%). Narcolepsy had prominent pernicious effects on various social, academic, family and mental aspects in our patients.

CONCLUSIONS:

In our Southern Chinese narcolepsy series, bi-modal peak pattern of age of onset, excess winter birth and tight association of HLA DQB1*0602 with cataplectic narcolepsy were found.

PMID:
18388176
[PubMed - indexed for MEDLINE]
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