Positive oligoclonal bands and CSF pleocytosis in narcolepsy type 1: A case report supporting the immune-mediated hypothesis.
作者： Ana Moreno-Estébanez , Iker Bilbao Villabeitia , Teresa Echeverria Guibert , Mar Mendibe Bilbao , Sabas Boyero Durán
DOI: 10.1016/J.JNEUROIM.2019.577111
关键词: CSF pleocytosis 、 Pleocytosis 、 Autoimmune encephalitis 、 Medicine 、 Excessive daytime sleepiness 、 Cataplexy 、 Orexin 、 Narcolepsy 、 Hypnopompic 、 Immunology
摘要: Abstract Narcolepsy-type 1 is a neurological sleep-disorder caused by selective loss of hypothalamic orexin/hypocretin-producing neurons whose underlying mechanism considered to be immune-mediated. We report the case 16 year-old girl with excessive daytime sleepiness, hypnagogic/hypnopompic hallucinations and cataplexy, fulfilling narcolepsy-type diagnostic criteria. She was HLA-DQB1*06:02/DQA1*01:02 positive. CSF analysis demonstrated positive IgG oligoclonal bands, pleocytosis hypocretin-1 below detection limit. Other autoimmune processes were excluded, including encephalitis. After treatment intravenous immunoglobulins sleep-related transiently improved for month. This case's inflammatory findings support role neuroinflammation in development genetically predisposed patients.
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