Ophthalmic Manifestations of Narcolepsy

Norman, Matthew E.; Dyer, John A.

doi:10.1016/s0002-9394(14)74173-x

Cited by 6 publications

(3 citation statements)

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“…The interpretation of pupillometry-derived measures of sleepiness is limited by a lack of normative data and a robust “single-best” measure. Several pupillometry-derived measures of sleepiness, e.g., pupillary diameter and stability, pupillary light reflex have been examined in narcolepsy with discrepant results (Kollarits et al, 1982; Pressman et al, 1984; Norman and Dyer, 1987; O’Neill et al, 1996). …”

Section: Introductionmentioning

confidence: 99%

Pupillometric Assessment of Sleepiness in Narcolepsy

et al. 2011

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Purpose: Excessive daytime sleepiness is highly prevalent in the general population, is the hallmark of narcolepsy, and is linked to significant morbidity. Clinical assessment of sleepiness remains challenging and the common objective multiple sleep latency test (MSLT) and subjective Epworth sleepiness scale (ESS) methods correlate poorly. We examined the relative utility of pupillary unrest index (PUI) as an objective measure of sleepiness in a group of unmedicated narcoleptics and healthy controls in a prospective, observational pilot study. Methods: Narcolepsy (n = 20; untreated for >2 weeks) and control (n = 56) participants were tested under the same experimental conditions; overnight polysomnography was performed on all participants, followed by a daytime testing protocol including: MSLT, PUI, sleepiness visual analog scale (VAS), ESS, and the psychomotor vigilance test (PVT). Results: The narcolepsy and control groups differed significantly on psychomotor performance and each measure of objective and subjective sleepiness, including PUI. Across the entire sample, PUI correlated significantly with objective (mean sleep latency, SL) and subjective (ESS and VAS) sleepiness, but none of the sleepiness measures correlated with performance (PVT). Among narcoleptics, VAS correlated with PVT measures. Within the control group, mean PUI was the only objective sleepiness measure that correlated with subjective sleepiness. Finally, in an ANCOVA model, SL and ESS were significantly predictive of PUI as measure of sleepiness. Conclusion: The role of PUI in quantifying and distinguishing sleepiness of narcolepsy from sleep-satiated healthy controls merits further investigation as it is a portable, brief, and objective test.

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Section: Introductionmentioning

confidence: 99%

Pupillometric Assessment of Sleepiness in Narcolepsy

et al. 2011

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“…Sleep-related respiratory dysrhythmia and central sleep apnoea are more frequent in narcolepsy than formerly believed (Chokroverty 1986). Eye symptoms such as blurred vision, diplopia, ptosis and involuntary flickering frequently occur (Broughton & Ghanem 1976, Norman & Dyer 1987. The overall disturbance in narcolepsy also includes disturbed nocturnal sleep.…”

Section: Hypnogogic Hallucinationsmentioning

confidence: 99%

“…This involves using an infrared pupillograph to measure the length of time a person maintains a stable pupillary diameter while seated in a dark room. Persons with narcolepsy either show progressive constriction over the 15-minute testing period or marked variation in pupillary diameter, but this test may not be definitive (Norman & Dyer 1987, Schmidt 1982.…”

Section: Assessment and Diagnosismentioning

confidence: 99%

Narcolepsy: a review of a common, life‐long sleep disorder

Cohen

1988

Journal of Advanced Nursing

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Narcolepsy is a severe debilitating chronic life-long sleep disorder that can be ameliorated but not cured. In the United States, its prevalence is at least 1 in 1000 making it more common than multiple sclerosis or Parkinson's disease. Its symptoms lead to severe lifestyle consequences, with profound impact on the affected persons, their interpersonal relationships, job, school experiences, and family life. Despite this, little has appeared in the nursing literature about the disorder. The most characteristic symptoms include uncontrollable excess daytime sleepiness, cataplexy (bilateral voluntary muscle weakness), sleep paralysis, hypnagogic hallucinations and disturbed night-time sleep. Characteristics of normal sleep are reviewed and compared with disturbances seen in narcolepsy. The aetiology, assessment, diagnosis, pharmacologic therapy, non-pharmacologic therapy and psychosocial issues are discussed along with needed research directions.

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