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ABSTRACT
Narcolepsy is a type of dyssomnia characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations. The signs of narcolepsy usually begin during the teenage years and it persists throughout the lifetime. Diagnosing narcolepsy in children can be challenging and the disorder can remain undiagnosed until adulthood. We describe here a case of childhood narcolepsy with cataplexy who was not diagnosed accurately during several admissions. The patient's signs were initially related to conversion disorder and she took inappropriate medications. However, after a polysomnography, the diagnosis of narcolepsy was established and she was treated appropriately with stimulant medications. (Anatolian Journal of Psychiatry 2017; 18(4):407-409)
Keywords: cataplexy, childhood, narcolepsy
ÖZ
Narkolepsi gün içinde aşırı uykulu olma, katapleksi, uyku paralizisi ve hipnogojik varsanılarla karakterize bir uyku bozukluğudur. Narkolepsi belirtileri genellikle çocukluk çağında başlayıp yaşam boyu sürmektedir. Çocuklarda narkolepsi tanısı koymak çoğu zaman zor olabilmekte ve bu bozukluk tanı konulamadan yetişkinliğe kadar sürebilmektedir. Bu yazıda, birçok kliniğe başvurmasına rağmen kesin tanısı konulamayan bir çocukluk çağı narkolepsi olgusu sunulmuştur. Hastanın belirtileri ilk olarak konversiyon bozukluğu ile ilişkilendirilmiş ve bu nedenle hastaya uygunsuz bir tedavi başlanmıştır. Ancak, polisomnografi uygulandıktan sonra narkolepsi tanısı konulmuş ve stimulan tedavisine geçilmiştir. (Anadolu Psikiyatri Derg 2017; 18(4):407-409)
Anahtar sözcükler: Katapleksi, çocukluk çağı, narkolepsi
INTRODUCTION
Narcolepsy is a chronic neurological disease usually occurring from childhood and persisting through adolescence and adulthood.1 It is believed that narcolepsy results from autoimmune destruction of hypocretin-producing neurons and dysfunction of hypocretin-1 and hypocretin-2 (orexin-A and orexin-B) hormones.2 These hormones are known as sleep-wake and rapid eye movement sleep-regulating neuropeptides.3 Patients with narcolepsy show excessive daytime sleepiness, sleep attacks, dyssomnia, metabolic abnormalities including obesity, and problems in social interaction and academic performance.1 The prevalence of narcolepsy in pediatric population remains unknown but can be estimated to be 20-60 per 100.000 in Western countries. However, recent studies suggest an increase of narcoleptic cases both in children and in adults.1
Narcolepsy is frequently under-recognized or under-diagnosed, especially when its...