A male in his mid-thirties suffers from falling asleep in inappropriate places during the daytime, and this problem caused several car accidents. Moreover, the male noticed that he becomes weak and even can fall while being excited and experiencing other strong emotions. Sleep at night is also associated with terror dreams and feelings of being paralyzed. It is important to discuss what diagnosis can be associated with these symptoms and what processes can cause such problems.
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A nerve impulse is transmitted between neurons with the help of chemicals. This process is known as synaptic transmission. Thus, a nerve impulse easily reaches an axon, but it is necessary for an axon to provoke the flow of calcium ions that stimulate the further release of neurotransmitters in order to reach the other neuron (Ahmed & Thorpy, 2010). These neurotransmitters allow the rapid transmission of the nerve impulse from one neuron to another each time it is observed. While comparing the activities of the central nervous system (CNS) and the peripheral nervous system (PNS), it is important to state that they have different structures and functions. The elements of the CNS are the brain and spinal cord; the elements of the PNS are nerves. The brain and spinal cord work to integrate and analyze the information received from nerves to coordinate senses, motor functions, and emotions among other processes (Luppi, Clement, Sapin, Gervasoni & Peyron, 2011). Thus, all commands received from the CNS based on the sensory data and further analysis are performed by the PNS.
The problems with sleep are associated with the affected brain functions. The possible diagnosis to explain the patient’s symptoms is narcolepsy which is a neurological disorder. Such symptoms as excessive daytime sleepiness, muscle weakness after experiencing strong emotions, and terrifying dreams are caused by the fact that the brain cannot regulate the neurological processes coordinating the sleep-wake cycle (Kornum, Faraco, & Mignot, 2011). Narcolepsy is usually caused by problems in the work of such neurotransmitters as hypocretins. Such a brain part as the hypothalamus produces hypocretins, but when it is affected, it is possible to observe the lack of hypocretins in order to coordinate the neuron signals (Ahmed & Thorpy, 2010). Therefore, such symptoms as the excessive daytime sleepiness, the muscle weaknesses, hallucinations associated with dreams, and the possible sleep paralysis are caused by the lack of hypocretins and the ineffective work of the hypothalamus, leading to narcolepsy.
When an electroencephalogram (EEG) is completed for the sleeping patient with narcolepsy, it is possible to observe the extreme activity associated with the rapid eye movement phase of sleep. After several seconds, it is possible to notice the loss of such activity that is followed by the rapid ocular movement (Kornum et al., 2011). From this point, the EEG allows focusing on specific features of the patient’s rapid eye movement phase of sleep to diagnose narcolepsy.
In spite of the fact that narcolepsy is classified as the chronic neurological and sleep disorder, the treatment plan can be proposed to the patient. The treatment should include both changes in physical activities and day schedules, as well as the drug treatment. First, it is important to plan the regular naps for the patient during the daytime. They are important to be prolonged, and they can add to the benefits of the nighttime sleep. In addition, it is necessary to provide the drug treatment, using methylphenidate, amphetamine, and dextroamphetamine (Ahmed & Thorpy, 2010). These medicines are effective to influence the quality of the patient’s sleep and daytime activities.
Ahmed, I., & Thorpy, M. (2010). Clinical features, diagnosis and treatment of narcolepsy. Clinics in Chest Medicine, 31(2), 371-381.
Kornum, B. R., Faraco, J., & Mignot, E. (2011). Narcolepsy with hypocretin/orexin deficiency, infections and autoimmunity of the brain. Current Opinion in Neurobiology, 21(6), 897-903.
Luppi, P. H., Clement, O., Sapin, E., Gervasoni, D., & Peyron, C. (2011). The neuronal network responsible for paradoxical sleep and its dysfunctions causing narcolepsy and rapid eye movement (REM) behavior disorder. Sleep Medicine Reviews, 15(3), 153-163.