Narcolepsy in Adolescence — A Missed Diagnosis: A Case Report

In this report, we present a case of an adolescent male with all four cardinal symptoms of narcolepsy who was misdiagnosed with epilepsy, psychosis, and depression. We also discuss various issues regarding narcolepsy in children and adolescents. Case Report Mr. A, an 18-year-old man, presented to psychiatry outpatient services with excessive daytime sleepiness of approximately 1.5 years’ duration. When the chronology of symptoms was evaluated, it was evident that about 1.5 years before presentation, the patient had an episode of high-grade fever (101–103?F) and was empirically treated for typhoid and malaria. Within a week of the fever episode while on antibiotics and antimalarial medications, he started experiencing excessive daytime sleepiness (EDS), i.e., despite good sleep at night, he started sleeping for 5 to 6 hours during the daytime, with total sleep duration/day being 15 to 16 hours/day. If not woken, he would continue to sleep for 19 to 20 hours/day. Initially, family members attributed his sleepiness to weakness from the fever and medications and did not consider it important. Because of continued EDS, the patient was unable to study, and this led to academic decline. He would often attempt to keep himself awake but would fall asleep between activities like studying, watching television, eating, etc. About three months after developing EDS, he started to notice that whenever he would laugh out loud or get angry, he would experience a sudden feeling of generali...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue adolescence misdiagnosis narcolepsy Source Type: research