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Willis on narcolepsy
http://www.100md.com 《英国精神病学杂志》2003年第1期
     304 Beverley Road, Anlaby, Hull HU10 7BG,5ti, http://www.100md.com

    Narcolepsy, a syndrome of unknown origin is characterised by excessive daytime sleepiness and often disturbed nocturnal sleep and pathological manifestations of REM sleep. From the Greek meaning to benumb or stupefy, narcolepsy is often called Gélineau’s syndrome, after the French physician Jean Baptiste Edouard Gélineau, who in 1880 gave the first comprehensive description.1 Westphal described it but more notable among early recognisable clinical portrayals is that of Thomas Willis.2 Willis did not use the word narcolepsy that was first coined by Gélineau as:5ti, http://www.100md.com

    "a rare neurosis ... characterised by an urgent necessity to sleep, sudden and of short duration which recurred at intervals more or less long."15ti, http://www.100md.com

    Willis noted that it was not just an embarrassing somnolence but a humoral disease. He thought that the body was able to produce its own narcotic substances.

    " ... a sleepy disposition—they eat and drink well, go abroad, take care well enough of their domestick affairs, yet whilst talking or walking, or eating, yea their mouthes being full of meat, they shall nod, and unless roused by others, fall fast asleep."3,4gf0(g, 百拇医药

    Adie and later Daniels recognised an association between daytime sleepiness,5 cataplexy, sleep paralysis, and hypnagogic hallucination—associations not known to Willis or Gélineau.gf0(g, 百拇医药

    Binns in 1842 is usually credited6 with the first report of paralysis which occurred in a daytime nap7: hence his term "daymares":gf0(g, 百拇医药

    "utter incapacity for motion or speech, difficult respirations, and extreme dread."gf0(g, 百拇医药

    More recently Mignot and others have shown that neurons that secrete hypocretins (primarily in the hypothalamus) are depleted or damaged in narcolepsy.8 And, they are absent or diminished in CSF of most narcoleptics studied. Although dogs have a mutation of the gene encoding hypocretins (orexins), so far consistent genetic anomalies have been rare in man.

    References:c, 百拇医药

    Gélineau J. De la narcolepsie. Gaz Hôp Paris 1880;53:626–8, 635–7.:c, 百拇医药

    Compston A. Thomas Willis (1621–1675). Paper read at the meeting of the Association of British Neurologists, Exeter, 6 April 2000.:c, 百拇医药

    Lennox WC. Thomas Willis on narcolepsy. Archives of Neurology and Psychiatry 1939;41:348–51.:c, 百拇医药

    Dewhurst K. Thomas Willis and the foundation of British neurology. In: Rose FC, Bynum WF, eds. Historical aspects of the neurosciences. New York: Raven Press, 1982:327–46.:c, 百拇医药

    Adie WJ. Idiopathic narcolepsy: a disease sui generis: with remarks on the mechanism of sleep. Brain 1926;49:275–306.:c, 百拇医药

    Pearce JMS. Early descriptions of sleep paralysis. J Neurol Neurosurg Psychiatry 1993;56:1302.:c, 百拇医药

    Binns E. The anatomy of sleep; or, the art of procuring a sound and refreshing slumber at will. London: J Churchill, 1842. cited by Bell CC et al. J Natl Med Assoc 1984;76:501–8.:c, 百拇医药

    Travis J. Brain-cell loss found in narcolepsy. Science News 2000 Sept 2.(J M S Pearce)