Neurologic disorders

Abstract

Excessive daytime sleepiness (EDS) is one of the symptoms that could accompany central nervous system disorders. EDS is the primary complaint in narcolepsy with cataplexy, narcolepsy without cataplexy, recurrent hypersomnia, idiopathic hypersomnia with long sleep time and idiopathic hypersomnia without long sleep time, diseases forming a group named hypersomnias of central origin. Pathophysiology, based on hypocretin neurons loss hypothesis, is known only in narcolepsy with cataplexy. That is why causal therapy does not exist for central hypersomnias EDS. The only available treatment is based on stimulants (and on sodium oxybate in narcolepsy). Sleep-related movement disorders (restless legs syndrome and periodic limb movements in sleep) affect the quality of sleep and in certain patients develops into EDS. Sleepiness is frequently reported in Parkinson's disease, traumatic brain injury, myotonic dystrophy, in stroke, and others. Treatment of EDS in these neurologic conditions is not well documented, but stimulants seem to be partially effective. This chapter provides more detailed view of symptoms, pathophysiology, and treatment of these conditions.