The concept of narcolepsy was first proposed in 1880 by the French physician Gélineau. The main symptoms include recurrent episodes of uncontrollable sleep during the day, cataplexy episodes, and nighttime sleep disturbances. Because the disease causes a decrease in alertness and muscle tone during an attack, which seriously affects their ability to learn, live and work, it is often misdiagnosed as epilepsy, transient ischemic attack, or psychiatric or psychological disorders.
Excessive daytime sleepiness is the most common symptom of narcolepsy. Almost all cases have excessive daytime sleepiness. Patients may feel uncontrollable sleepiness during the day and may even fall asleep suddenly. A nap can temporarily relieve this feeling of drowsiness and allow the patient to stay awake for a while. In a monotonous, non-stimulating environment, patients are more likely to fall asleep. Some people may have sudden sleep episodes when walking, eating, or talking, which can cause them to have some unconscious behaviors or stereotyped movements. This condition of daytime hypersomnolence occurs every day, regardless of how much sleep the patient has at night, and is accompanied by fluctuations in attention and psychomotor alertness.
Cataplexy seizures are another important symptom of narcolepsy. It manifests as a sudden onset of bilateral skeletal muscle tone in the awake state, while consciousness is relatively preserved. Cataplexy seizures are thought to be caused by dissociation and insertion of rapid eye movement sleep segments. This is the most characteristic clinical manifestation of narcolepsy. Cataplexy attacks usually occur within 1 year of their onset, but there are some rare cases where cataplexy occurs first. Cataplexy seizures are usually triggered by positive emotions such as laughter and joy. But negative emotions such as anger or sadness can also trigger cataplexy episodes. Symptoms of cataplexy attacks can range from local skeletal muscle weakness, such as drooping eyelids, tongue prolapse, facial laxity, and even blurred vision (eye muscle involvement), to the neck, upper limbs, and lower limbs, resulting in head dropping, upper limb dropping, knee bending, body leaning forward, and even falling. Respiratory muscles are usually not affected. Cataplexy attacks are usually short-lived, less than 2 minutes, and can be quickly and fully recovered. The frequency of cataplexy attacks ranges from 1 in a few months to several times a day. Sometimes intense emotional stimuli can trigger persistent cataplexy episodes, which can last for hours in severe cases, which is called status cataplexy.
In addition, patients with narcolepsy may also have nocturnal sleep disturbances. This includes problems such as nighttime sleep disruption, poor sleep quality, REM sleep behavior, etc. These problems not only affect the quality of sleep of patients, but can also lead to fatigue and drowsiness during the day. Sleep problems are becoming more common these days, and many people have experienced an increase in the number and duration of awakenings, as well as a decrease in sleep efficiency. Some people may even experience sleep paralysis, hypnagonic hallucinations, nightmares, parasomnias, and REM sleep behavior disorders. Among them, dream-related hypnagogic hallucinations and sleep paralysis are the most characteristic symptoms, occurring in about 33% and 80% of patients.
Pre-sleep hallucinations, which occur during the wake-sleep transition, are dream-like experiences that are often horrific or unpleasant. This hallucination can occur before awakening, and occurs in about 20% to 65% of people with narcolepsy. Hallucinations come in many forms and can be visual, somatosensory, auditory, or a combination of multiple senses, such as "out-of-body" sensations. Sometimes, this hallucination occurs with cataplexy or occurs after cataplexy or when sleep is paralyzed. Sleep paralysis is a phenomenon that occurs during sleep or wakefulness, in which the patient is awake but unable to perform normal movements or speech, which lasts for tens of seconds to minutes. Patients need to be controlled by consciousness or touched by the outside world to return to normal. During this process, patients often experience difficulty breathing, accompanied by various forms of hallucinations, especially frightening experiences.
For this disease, the ** method of Baicao Xingshen Tang is divided into three stages.
The first stage is based on replenishing qi and nourishing blood, with the purpose of opening up blood circulation, nourishing the viscera, enhancing the body's metabolic function, and at the same time removing turbidity from the body to control the disease.
In the second stage, drugs are used to strengthen qi and spleen, nourish the liver and kidneys, open up blocked meridians, dispel phlegm and dampness, and raise yang and lower yin, so as to restore the balance of yin and yang in the body and alleviate the disease.
In the third stage, the effect of the drug is to restore the qi in the human body, and to clear the body, so as to achieve the effect of awakening and opening the body, and restore the excitability of the nerves.
People with narcolepsy face a lot of trouble in their daily lives. They often fall asleep suddenly while attending class, crossing the street, driving, eating, or communicating. For children, this situation is often misunderstood by parents and teachers as laziness, spinelessness, lack of goals and ambitions, etc. At the same time, they are often ridiculed by friends, classmates or colleagues. What's more, it is very dangerous to fall asleep suddenly while driving or crossing the street, so timely measures need to be taken to deal with the situation.