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1例41岁男性,间断吸食苯丙胺类兴奋剂麻古(主要含有甲基苯丙胺和咖啡因)2年余,1年前开始自行减少剂量,就诊前4周完全停止吸食。戒断15d患者出现昼间嗜睡,频繁发作,10～20min发作1次,每次持续数分钟至数十分钟,并多次出现“梦魇”现象。多导睡眠图示平均睡眠潜伏期缩短至80s。诊断为发作性睡病,考虑为停用麻古所致。鼓励患者继续坚持戒断,增加体力活动和视听刺激,以避免白天睡眠。给予阿米替林25mg晚间睡前口服。2周后,患者睡眠障碍消失。
A 41-year-old man discontinued taking amphetamine-type stimulant Ma Gu (mainly containing methamphetamine and caffeine) for more than two years. He started to reduce the dose one year ago and stopped taking it for 4 weeks before treatment. 15d withdrawal of patients with daytime drowsiness, frequent seizures, attack 10-20min 1, each lasting several minutes to tens of minutes, and many “nightmare ” phenomenon. Polysomnography showed the average sleep latency was shortened to 80s. Diagnosis of narcolepsy, considered to be disabled due to Ma Gu. Encourage patients to continue to adhere to withdrawal, increase physical activity and audio-visual stimulation to avoid sleep during the day. Give amitriptyline 25mg orally at night before going to bed. Two weeks later, the patient’s sleep disorder disappeared.