Diagnosis of Narcolepsy with cataplexy
Narcolepsy is an under-diagnosed and misdiagnosed disorder; only 25% of individuals with narcolepsy are diagnosed with this condition, and on average it can take up to 7 to 10 years for a proper diagnosis. Patients are often mistakenly diagnosed with other conditions, such as psychiatric or emotional problems. This is due to the many overlapping symptoms and similarities between narcolepsy and to other neurological disorders such as schizophrenia, depression, bipolar disease and Parkinson's Disease. In some cases, narcolepsy can co-exist with these comorbid illnesses as well, making the diagnosis and management of these conditions much more complicated. Therefore, a comprehensive workup including collecting a thorough history of signs and symptoms, lab tests, and sleep studies are some of the necessary components that are required to make an accurate diagnosis of narcolepsy.
The following are the diagnostic criteria of narcolepsy with cataplexy:
- Presence of EDS almost daily for at least 3 months
- Definite history of cataplexy
- Sudden and transient (less than 2 minutes) episodes of loss of muscle tone
- Generally bilateral
- Triggered by emotions (usually laughing and joking)
- Hypersomnia is not better explained by another disorder
● May be confirmed by:
•Polysomnogram ruling out other causes of disrupted nocturnal sleep and demonstrating at least 6 hours of sleep •Multiple Sleep Latency Test (MSLT): mean daytime sleep latency < 8 minutes and > 2 sleep onset REM periods or •A CSF hypocretin-1 level < 110 pg/ml
References
1. Ahmed I, Thorpy M. Clinical features, diagnosis and treatment of narcolepsy. Clin Chest Med 2010; 31: 371 – 381
2. Benca RM. Narcolepsy and excessive daytime sleepiness: Diagnostic considerations, epidemiology, and comorbidities. J Clin Psychiatry 2007;68[suppl 13]:5–83.
3. http://trihealth.adam.com/content.aspx?productId=10&pid=10&gid=000098#adamHeading_7
4. http://www.narcolepsynetwork.org/about-narcolepsy/faq/
Images:
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch
1. Ahmed I, Thorpy M. Clinical features, diagnosis and treatment of narcolepsy. Clin Chest Med 2010; 31: 371 – 381
2. Benca RM. Narcolepsy and excessive daytime sleepiness: Diagnostic considerations, epidemiology, and comorbidities. J Clin Psychiatry 2007;68[suppl 13]:5–83.
3. http://trihealth.adam.com/content.aspx?productId=10&pid=10&gid=000098#adamHeading_7
4. http://www.narcolepsynetwork.org/about-narcolepsy/faq/
Images:
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch