Abstract
Hypersomnolence or narcolepsy may be the initial finding in neuromyelitis optica spectrum disorders (NMOSD); therefore, it is important in clinical evaluation. Aquaporin 4 (AQP4) is densely located in the periventricular zone of the hypothalamus, where hypocretin is concentrated. Therefore, anti-AQP4 antibodies in NMOSD may cause damage to this zone, resulting in decreased hypocretin and hypersomnia or narcolepsy. In our study, 10 NMOSD patients diagnosed with clinical, radiological, and laboratory findings were compared with 22 multiple sclerosis patients selected as the control group and 22 healthy individuals. The Epworth sleepiness scale and the Stanford sleepiness scale were used to assess excessive daytime sleepiness. Our study supports the fact that hypersomnolence is higher in the NMOSD group, independent of other factors that may cause the tendency to sleep.
Keywords:
Hypersomnolence, NMOSD, narcolepsy, EDS
References
1Papp V, Magyari M, Aktas O, et al. Worldwide incidence and prevalence of neuromyelitis optica: a systematic review. Neurology. 2021;96(2):59-77.
2Wu Y, Zhong L, Geng J. Neuromyelitis optica spectrum disorder: Pathogenesis, treatment, and experimental models. Mult Scler Relat Disord. 2019;27:412-418.
3Lana-Peixoto MA, Talim N. Neuromyelitis Optica Spectrum Disorder and Anti-MOG Syndromes. Biomedicines. 2019;7(2):42.
4Kısabay Ak A, Sarıtaş AŞ, İnalkaç Gemici Y, Yılmaz H. Clinical Approach Hypersomnia of Central Origin and Differential Diagnosis. J Turk Sleep Med. 2022;9(2):95-114.
5Oğan U, Benbir Şenel G. Uyku Nörofizyolojisi ve Hastalıkları. Emsal Matbaa. Ankara: Bayçınar Tıbbi Yayıncılık; 2022.
6Deguchi K, Kono S, Deguchi S, et al. A patient with anti-aquaporin 4 antibody presenting hypersomnolence as the initial symptom and symmetrical hypothalamic lesions. J Neurol Sci. 2012;312(1-2):18-20.
7H He D, Zhang A, Li Y, Cai G, Li Y, Guo S. Autoimmune aquaporin-4 induced damage beyond the central nervous system. Mult Scler Relat Disord. 2017;18:41-46.
8Nishino S, Kanbayashi T. Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin/orexin system. Sleep Med Rev. 2005;9(4):269-310.
9Stavrou M, Francis L, Tshuma N, Schmierer K. Neuromyelitis optica spectrum disorder presenting as rhomboencephalitis. BMJ Case Rep. 2018;2018: bcr2017222255.
10Daida K, Ogaki K, Hayashida A, et al. Somnolence Preceded the Development of a Subthalamic Lesion in Neuromyelitis Optica Spectrum Disorder. Intern Med. 2020;59(4):577-579.
11Bollu PC, Manjamalai S, Thakkar M, Sahota P. Hypersomnia. Mo Med. 2018;115(1):85-91.
12KKanbayashi T, Shimohata T, Nakashima I, et al. Symptomatic narcolepsy in patients with neuromyelitis optica and multiple sclerosis: new neurochemical and immunological implications. Arch Neurol. 2009;66(12):1563-1566.
