Narcolepsy: a clinical review. Issue 5 (15th May 2014)

• Record Type: Journal Article
• Authors: Leschziner, Guy
• Is Part Of: Practical neurology. Volume 14:Issue 5(2014)
• Page Start: 323
• Page End: 331
• Publication Date: 2014-05-15
• Subjects: Sleep Disorders; Neurology -- Periodicals; 616.8005
• DOI: 10.1136/practneurol-2014-000837
• Languages: English
• ISSNs: 1474-7758

Abstract

Abstract : Despite the classic tetrad of clinical features that typify it, narcolepsy remains much under-diagnosed, in part, because of the wide spectrum of clinical phenotypes, but also because of its insidious onset, usually in a young person. The median time to diagnosis from first symptoms remains very long, around 10 years in the UK. Conversely, in the specialist setting, it is likely over-diagnosed, largely because of failure to exclude other causes of hypersomnia. There is an over-reliance on a biological marker of the condition, the multiple sleep latency test (MSLT), which, like many tests, has a significant false-positive and false-negative rate. This review aims to discuss some of the difficulties in achieving a diagnosis, interpretation of investigations, differential diagnosis, and appropriate management of patients with narcolepsy.