CHEST Timothy J. Young, MD; and Michael H. Silber, MBChB CNS CNS (hypersomnia); (idiopathic hypersomnia); (narcolepsy); (recurrent hypersomnia) CSF = cerebrospinal fluid; EDS = excessive daytime sleepiness; HLA = human leukocyte antigen; IH = idiopathic hypersomnia; MSLT = multiple sleep latency test; RBD = rapid eye movement sleep behavior disorder; REM = rapid eye movement; SOREM = sleep onset rapid eye movement sleep 9% [1] (EDS) From the Sleep Disorders Center, Mayo Clinic College of Medicine, Rochester, MN. This research was supported by Mayo Piscopo Funds. Correspondence to: Michael H. Silber, MBChB, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905; ( 1) e-mail: msilber@mayo.edu www.chestjournal.org.cn CHEST 2007 1 4 1 37
1 (1) 2005 2 [5] REM NREM 5-1 ( 2) CNS 1 2 (1) REM NREM 19 10 y Yoss [6] 1957 EDS [2] 5-10 y (REM) REM 5- REM EDS EDS [7] [8] 1 2 (Orexin) A B [3] [7] 64% 80% [9] 2min γ - (galanin) [10] [4] ( ) 86% [11, 12] 25% 38
(prodynorphin) REM [22, 23] 63% 6% [12, 13] [14] 24 h [15] (HLA) DQB1*0602 [24] REM 85% 93% [25] (RBD) RBD 36% [15] RBD (35% 56%) [26] 12% 38% 1998 1% 2% [27] [16] [17] [28] (CSF) CSF [18] [29] 1 IgG [19] [30] [31] CNS 20 HLA DQB1*0602 N- CSF IgG [20] / [21] 10% 86% CSF 2 [12] CSF C [12] CSF Kleine-Levin ( ) 2wk 1wk (MSLT) www.chestjournal.org.cn CHEST 2007 1 4 1 39
3 (1) (2) 100 200 mg 400 mg 500mg/mL 9g 5 10 20 mg 100 mg 20 mg CNS (Concerta 18 36 54 mg 100 mg McNeil Fort Washing- CNS ton, PA) 5 10 mg 100 mg CNS (Dexedrine 5 10 15 mg 100 mg Spansules GlaxoSmith- CNS Kline) 5 10 15 20 30 mg 100 mg (Adderall Shire Phar- CNS maceuticals Basingstoke, UK) 5 10 15 20 30 mg 100mg (Adderall XR Shire CNS Pharmaceuticals) 5mg 80 mg CNS (1) Richardson [69] (2) Littner [70] 4 5 EDS 15 min REM MSLT SOREM MSLT [32] 4 HLA 10.4 min s DQB1*0602 [12, 34] 4.2 min CSF (3.1 2.9) min 8 min 2 REM (SOREM) [33] REM ( ) [35 37] HLA CSF CSF 40
[38] [39] [46 49] 1 [46] 1 [47] EDS 5 Ig [48, 49] 3 1 [40] ( 3) (IH) 1 1998 [41] (von Economo ) 20 Roth [50] [51, 52] IH [5] IH [42] 10 h EDS ( ) IH EDS 10 h 5-42 2002 [50] 25% 60% [43, 44] γ - 21% γ - -B 2.5 4 h 1 IH [45] 2005 MSLT EDS 8 min 2 γ - SOREM MSLT 24 36 h IH www.chestjournal.org.cn CHEST 2007 1 4 1 41
[58] MSLT 10 h MSLT 4 8 y [59, 60] 8min 2 SOREM IH EDS 5- [61] Kleine- Levin [53] 4 : 1 4 [54] 2 186 Kleine-Levin CNS [55] 61% 15 3 4 mo 1 4y 18 h MSLT 2 SOREM [62] CSF 1 [56] CSF [53] 1 MRI CT [57] 4 3 [53] CNS 42
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