Narcolepsy (pathology)

Answer 1

Rare, long term brain condition that causes patient to fall asleep at inappropriate times (heritable disease)

Question 2

Risk factors for narcolepsy

Answer 2

• Young
• Cataplexy- sudden onset of muscle weakness
• Excessive daytime somnolence
• Hypnagogic hallucinations- at onset of sleep
• Hypnopompic hallucinations- coming around from sleep

Question 3

Investigations for narcolepsy

Answer 3

• Polysomnography
• Multiple sleep latency test
  • Sleep onset at REM > 1 (SOREM >1)
  • Fall asleep in < 8 min
• Low CSF orexin (neuropeptide)

Question 4

Management of narcolepsy

Answer 4

Management (not curative)

• MODAFINIL stimulant 1st line
• Dexamphetamine stimulant
• Venlafaxine (SNRI) for cataplexy
• Sodium oxybate (Xyrem)