1型发作性睡病共病精神分裂症1例报告  

Narcolepsy Type 1 With Comorbid Schizophrenia: A Case Report

作　　者：王美鸥 马菁 李思迅 张岚[1] WANG Mei-ou;MA Jing;LI Si-xun;ZHANG Lan(Department of Psychiatry,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院精神科,成都610041

出　　处：《四川大学学报（医学版）》2023年第2期444-446,共3页Journal of Sichuan University(Medical Sciences)

摘　　要：本文报告了1例18岁,1型发作性睡病共病精神分裂症的男性患者的临床资料。患者首发症状主要为白天嗜睡,后出现幻觉、妄想、异常言行等精神病性症状。入院后完善辅助检查:日间多次睡眠潜伏期试验提示平均睡眠潜伏期为2 min,脑脊液下丘脑分泌素-1为90.56 pg/mL。诊断为:1.精神分裂症,2.发作性睡病。予以抗精神病药物及行为治疗后患者幻觉、异常言行消失,妄想及白天嗜睡明显减少。1型发作性睡病与精神分裂症的症状表现存在重叠,临床上易导致误诊和漏诊。本文对该案例进行讨论,以期为临床诊治1型发作性睡病共病精神分裂症提供参考。We present the case of an 18-year-old male patient who had narcolepsy type 1 and comorbid schizophrenia. The patient’s first symptom was mainly excessive daytime sleepiness, which was followed by psychotic symptoms, including hallucinations, delusions, and abnormal speech and behaviors. After admission to the hospital, the patient underwent a number of ancillary tests. Multiple sleep latency test(MSLT) showed that the mean sleep latency was2 min and the hypocretin-1 was found to be 90.56 pg/mL. The patient was diagnosed with: 1) schizophrenia;2) narcolepsy. After receiving antipsychotic drugs and behavioral therapy, the patient’s hallucinations and abnormal speech and behaviors disappeared, and delusions and excessive daytime sleepiness decreased significantly. The symptoms and manifestations of narcolepsy type 1 overlaps with those of schizophrenia, which may lead to misdiagnosis and underdiagnosis in clinical practice. The case is presented with a view to providing a reference for the clinical diagnosis and treatment of narcolepsy type 1 with comorbid schizophrenia.

关 键 词：发作性睡病 精神分裂症 共病 

分 类 号：R740[医药卫生—神经病学与精神病学] R749.3[医药卫生—临床医学]