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Narcolepsy in Southern Chinese patients: clinical characteristics, HLA typing and seasonality of birth
  1. Y K Wing1,
  2. L Chen1,
  3. S Y Y Fong1,
  4. M H L Ng2,
  5. C K W Ho1,
  6. S H Cheng2,
  7. N L S Tang3,
  8. A M Li4
  1. 1
    Department of Psychiatry, The Chinese University of Hong Kong, Prince of Wales and Shatin Hospitals, Shatin, Hong Kong SAR
  2. 2
    Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales, Shatin, Hong Kong SAR
  3. 3
    Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales, Shatin, Hong Kong SAR
  4. 4
    Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales, Shatin, Hong Kong SAR
  1. Dr Y K Wing, Professor, FRCPsych, FHKAM (Psych), Director of Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; ykwing{at}cuhk.edu.hk

Abstract

Objective: To report clinical characteristics, human leukocyte antigen (HLA) typing and seasonality of birth of a series of 54 Southern Chinese patients suffering from narcolepsy.

Methods: All subjects underwent detailed medical and psychiatric interviews and a standardised nocturnal polysomnogram followed by a daytime Multiple Sleep Latency Test. Each subject also completed a set of sleep questionnaires. HLA typing was performed in 91% of subjects.

Results: A total of 78% and 22% of patients were diagnosed with suffering from cataplectic and non-cataplectic narcolepsy, respectively. The majority (n = 47, 87%) of patients were referred to our sleep clinic for excessive daytime sleepiness (EDS). The cataplectic narcolepsy differed from non-cataplectic narcolepsy by having more rapid eye movement (REM)-related clinical symptoms (more sleep paralysis and sleep-related hallucination) and sleep disturbances (shorter REM latency), as well as tighter association with HLA DQB1*0602. A bi-modal peak pattern was observed at 11 and 39 years old. A similar bi-modal pattern also occurred for EDS and cataplexy. Excess winter births were observed for this series of patients. 81% of patients with cataplectic narcolepsy were DQB1*0602-positive. There were no differences between early- and late-onset cases in the association with positive DQB1*0602 (71.4% vs 60%). Narcolepsy had prominent pernicious effects on various social, academic, family and mental aspects in our patients.

Conclusions: In our Southern Chinese narcolepsy series, bi-modal peak pattern of age of onset, excess winter birth and tight association of HLA DQB1*0602 with cataplectic narcolepsy were found.

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Footnotes

  • Competing interests: None declared.

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