1/10/2023 0 Comments Icd 10 narcolepsy with cataplexy4 Diagnostic delay is less in those with cataplexy and in younger patients. 3 The interval between onset and diagnosis can be long, with a median of 10.5 years in one study. Onset can occur at any age 2 but is commonest in those aged 10-19, in whom an incidence of 3.84 per 100 000 person years has been reported. 2 Information on incidence is more limited. 1 Estimates of prevalence generally range between 25 and 50 per 100 000, though might be less in some populations, possibly because of differences in genetic susceptibility or exposure to aetiological risk factors. Diagnosis is based on clinical criteria and can be confirmed by polysomnography followed by a multiple sleep latency test. Narcolepsy is a chronic disorder presenting with excessive daytime sleepiness, often accompanied by a transient loss of muscle tone triggered by strong emotion (cataplexy). Because of variable delay in diagnosis, however, the risk might be overestimated by more rapid referral of vaccinated children. The attributable risk was estimated as between 1 in 57 500 and 1 in 52 000 doses.Ĭonclusion The increased risk of narcolepsy after vaccination with ASO3 adjuvanted pandemic A/H1N1 2009 vaccine indicates a causal association, consistent with findings from Finland. The relative incidence from the self controlled cases series analysis in those with a diagnosis by July 2011 with onset from October 2008 to December 2010 was 9.9 (2.1 to 47.9). In those with a diagnosis by July 2011 the odds ratio was 14.4 (95% confidence interval 4.3 to 48.5) for vaccination at any time before onset and 16.2 (3.1 to 84.5) for vaccination within six months before onset. Eleven had been vaccinated before onset seven within six months. Results Case notes for 245 children and young people were reviewed 75 had narcolepsy (56 with cataplexy) and onset after 1 January 2008. The incidence of narcolepsy within six months of vaccination compared with the incidence outside this period measured with the self controlled cases series method. Main outcome measures The odds of vaccination in those with narcolepsy compared with the age matched English population after adjustment for clinical conditions that were indications for vaccination. Participants Children and young people aged 4-18 with onset of narcolepsy from January 2008. Setting Sleep centres and paediatric neurology centres in England. Vaccination and clinical histories were obtained from general practitioners. Clinical information and results of sleep tests were extracted from hospital notes between August 2011 and February 2012 and reviewed by an expert panel to confirm the diagnosis. Objective To evaluate the risk of narcolepsy in children and adolescents in England targeted for vaccination with ASO3 adjuvanted pandemic A/H1N1 2009 vaccine (Pandemrix) from October 2009.ĭesign Retrospective analysis.
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