Research Narcolepsy. Discuss the symptoms, diagnosis and treatment of the autoim

Question

Research Narcolepsy. Discuss the symptoms, diagnosis and treatment of the autoimmune disease that you have chosen. Make sure to include:

Any side effects of current treatment options,
Include any new treatments that may be available.
Why is it difficult to diagnose an autoimmune disease?

Case Study: A 45-year-old woman, otherwise healthy, presents with the following symptoms:

Itchy eyes
Difficulty swallowing
Problems eating
Mouth sores
Mouth pain
Fatigue
Swollen glands

Research these symptoms to find out what this patient is suffering from. Once you know the specific autoimmune disease that she is suffering from:

Recommend some possible treatments to ease her symptoms.
Let her know if her disease is life-threatening.
Is there a higher risk of lymphoma if you have this specific disease? Why or why not?
Discuss any possible complications from having this disorder.
What is her overall prognosis for living with this disease?

Explanation / Answer

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle, as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis -- which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

Causes of Narcolepsy:

The cause of narcolepsy is not known; however, scientists have made progress toward identifying genes strongly associated with the disorder. These genes control the production of chemicals in the brain that may signal sleep and awake cycles. Some experts think narcolepsy may be due to a deficiency in the production of a chemical called hypocretin by the brain

In addition, researchers have discovered abnormalities in various parts of the braininvolved in regulating REM sleep. These abnormalities apparently contribute to symptom development. According to experts, it is likely narcolepsy involves multiple factors that interact to cause neurological dysfunction and REM sleep disturbances.

Symptoms:

·         Excessive daytime sleepiness

·         Cataplexy: This symptom consists of a sudden loss of muscle tone that leads to feelings of weakness and a loss of voluntary muscle control. It can cause symptoms ranging from slurred speech to total body collapse, depending on the muscles involved, and is often triggered by intense emotions such as surprise, laughter, or anger.

Diagnosis

A physical exam and exhaustive medical history are essential for proper diagnosis of narcolepsy. However, none of the major symptoms is exclusive to narcolepsy. Several specialized tests, which can be performed in a sleep disorders clinic or sleep lab, usually are required before a diagnosis can be established. Two tests that are considered essential in confirming a diagnosis of narcolepsy are the polysomnogram (PSG) and the multiple sleep latency test (MSLT).

The PSG is an overnight test that takes continuous multiple measurements while a patient is asleep to document abnormalities in the sleep cycle. A PSG can help reveal whether REM sleep occurs at abnormal times in the sleep cycle and can eliminate the possibility that an individual's symptoms result from another condition.

The MSLT is performed during the day to measure a person's tendency to fall asleep and to determine whether isolated elements of REM sleep intrude at inappropriate times during the waking hours. As part of the test, an individual is asked to take four or five short naps usually scheduled two hours apart.

Treatment:

Although there is no cure for narcolepsy, the most disabling symptoms of the disorder (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Sleepiness is treated with amphetamine-like stimulants, while the symptoms of abnormal REM sleep are treated with antidepressant drugs.

There has recently been a new medicationapproved for those who suffer from narcolepsy with cataplexy. This drug, called Xyrem, helps people with narcolepsy get a better night's sleep, allowing them to be less sleepy during the day. Patients with narcolepsy can be substantially helped -- but not cured -- by medical treatment.

Lifestyle adjustments such as avoiding caffeine, alcohol, nicotine, and heavy meals, regulating sleep schedules, scheduling daytime naps (10-15 minutes in length), and establishing a normal exercise and meal schedule may also help to reduce symptoms.

New treatments to cure narcolepsy:

Hypocretin-based therapies

Cell transplantation and stem cells

Hypocretin peptide replacement

Autoimmune diseases affect up to 50 million Americans, according to the American Autoimmune Related Diseases Association (AARDA). An autoimmune disease develops when your immune system, which defends your body against disease, decides your healthy cells are foreign. As a result, your immune system attacks healthy cells. An autoimmune disease can affect one or many different types of body tissue, depending on the type. It can also cause abnormal organ growth and changes in organ function.

There are as many as 80 types of autoimmune diseases. Many of them have similar symptoms, which makes them very difficult to diagnose. It’s also possible to have more than one at the same time. Autoimmune diseases usually fluctuate between periods of remission (few or no symptoms) and flare-ups (worsening symptoms). Currently, treatment for autoimmune diseases focuses on relieving symptoms and preventing complications because there is no curative therapy.

Autoimmune diseases often run in families, and 75 percent of those affected are women, according to AARDA. African-Americans, Hispanics, and Native Americans also have an increased risk of developing an autoimmune disease.

The following are some of the more common autoimmune diseases:

Diagnosing an autoimmune disease involves identifying the antibodies your body is producing.

The following tests are used to diagnose an autoimmune disease:

case study symptoms are indicate that woman suffering from sjogren syndrome  

Sjogren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The condition may affect other parts of the body, including the kidneys and lungs.

Causes

The cause of Sjogren syndrome is unknown. It is an autoimmune disorder. This means the body attacks healthy tissue by mistake. The syndrome occurs most often in women ages 40 to 50. It is rare in children.

Primary Sjogren syndrome is defined as dry eyes and dry mouth without another autoimmune disorder.

Secondary Sjogren syndrome occurs along with another autoimmune disorder, such as:

Symptoms

Dry eyes and dry mouth are the most common symptoms of this syndrome.

Eye symptoms:

Mouth and throat symptoms:

Other symptoms may include:

Tests

A physical test reveals dry eyes and mouth. There may be mouth soresbecause of the mouth dryness.

You may have the following tests:

Treatment

The goal is to relieve symptoms.

Disease modifying drugs (DMARDs) similar to those used for rheumatoid arthritis may improve the symptoms of Sjogren syndrome. These include tumor necrosis factor (TNF) inhibiting drugs such as Enbrel, Humira or Remicaide.

Some things you can do to ease symptoms include:

Talk with your dentist about:

To prevent dental decay that can be caused by mouth dryness:

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