[Narcolepsia]

Narcolepsy is a chronic neurologic disease whose main features are excessive daytime sleepiness and cataplexy. It is a rare disorder which is most frequently sporadic. The age of onset shows two peaks. Both genetic and environmental factors play in its pathophysiolgy. Association with a specific HLA antigen and implication of the hypocretin system are very important findings. Narcolepsy's diagnosis is based on clinical findings but polysomnographic monitoring and multiple sleep latency test are usually necessary. Treatment of narcolepsy has been substantially modified with the advent of Modafinil which is effective as amphetamine with less undesirable effects. New etiologic treatments, such as hypocretin agonists, are currently being developed

[Thoracic involvement revelating lymphomas: about 17 cases]

Thoracic manifestations of lymphomas are frequent and various. They are frequently described as secondary than as a primary manifestation. This work aims to analyze the clinical, radiological, and prognostic characteristics of initial thoracic features of lymphomas. The authors stress the diagnosis and therapeutic difficulties which they encountered. We report a retrospective work of initial thoracic involvement of lymphomas and their radiologic features observed in 17 patients hospitalized in pneumology service of Sfax. There were 10 cases of non Hodgkin's lymphoma and 7 cases of Hodgkin disease. For the patients with non Hodgkin's lymphoma, the mediastinal involvement was present in 8 cases. The parenchymal involvement was noted among 2 patients such as nodules or masses, with concomitant mediastinal lymph nodes. The pleural effusion such as pleurisy or solid mass was seen in 3 cases. Pericardial and parietal involvements were noted in one case. For the patients with Hodgkin's disease, the mediastinal lymph nodes were seen among 6 patients. The parenchymal involvement was noted in one case. One case of primary thymic lymphoma involvement and one case of tracheal involvement were noted. No case of pleural effusion was deplored. Initial thoracic involvements, rarely described, cause a variety of features which are often nonspecific. The diagnosis, often difficult, has beneficiated, from imaging and endoscopy's progress. However, treatment should be optimized in order to improve the prognosis which is also reserved particularly in non Hodgkin lymphoma