A case of fatal familial insomnia: diagnostic and therapeutic approaches

• Published in: Neurocase Vol. 28; no. 1; pp. 131 - 134
• Main Authors: Rose, Deborah K, Liu, Andy J
• Format: Journal Article
• Language: English
• Published: England 01.02.2022
• Subjects: Brain - metabolism; Humans; Insomnia, Fatal Familial - diagnosis; Insomnia, Fatal Familial - genetics; Insomnia, Fatal Familial - therapy; Neuroimaging; Prions - genetics; Prions - metabolism; Sleep Initiation and Maintenance Disorders - diagnosis; Sleep Initiation and Maintenance Disorders - etiology; Sleep Initiation and Maintenance Disorders - therapy; fatal familial insomnia; FFI; Prion disease
• ISSN: 1355-4794; 1465-3656
• DOI: 10.1080/13554794.2021.2025249

 Fatal Familial Insomnia (FFI) is an uncommon but fatal genetic condition that is characterized by severe progressive insomnia, dysautonomia, neuropsychiatric changes, and gait instability. Diagnostic workup includes genetic testing, EEG, MRI imaging of the brain, polysomnography, and CSF analysis. MRI brain imaging may be notable for areas of restricted diffusion in the thalamus. Therapeutic approaches are centered on symptom management, predominantly for insomnia. It is important for clinicians to consider FFI in patients presenting with progressive insomnia, cognitive deficits, and gait instability, and to direct patients and families toward genetic counseling and palliative care services.