ANESTHESIA IN PATIENTS SUFFERING FROM NAR COLEPSY

Narcolepsy is a disturbance of the sleep-wake cycle. The condition is characterized by irresistible sleep attacks, cataplexy, hallucinations , sleep paralysis, twilight state and nocturnal sleep disorders. For t he diagnosis, sleep attacks, cataplexy and pathological changes have t o be revealed by the multiple sleep latency test (MSLT) and in the pol ysomnographic recording. The aetiology of the disease is unknown. The association between narcolepsy and HLA-DR2 and HLA-DQw1 in more than 9 0% of the sufferers suggests an autoimmune basis; to date, however, th is has not yet been proven It is probable that narcolepsy is of signif icance for anaesthesia, and appears in particular as a result of posto perative disorders of vigilance. Sleep paralysis or twilight state mus t be distinguished from metabolic, respiratory, and drug-induced distu rbances and from a central anticholinergic syndrome. Cholinergic neuro nes seem to play a particular role in disorders of vigilance. lpl the presence of postoperative disorders of vigilance, narcolepsy should be considered in the differential diagnosis.