![]() ![]() These conditions include but are not limited to brain tumors, head trauma, traumatic brain injury, multiple sclerosis, encephalomyelitis, vascular disorders, strokes, degenerative diseases, and inherited diseases (e.g., Neimann-Pick type C, myotonic dystrophy, Prader-Willi). Neurologic insults or medical conditions associated with secondary narcolepsy can be localized to the hypothalamus or they can be global. In secondary narcolepsy (narcolepsy that is due to a medical condition), excessive daytime sleepiness must be present almost daily for at least three months, and a significant underlying medical or neurological disorder that accounts for the daytime sleepiness must be present along with one of the following criteria:a) a definitive history of cataplexy, orī) atypical (questionable) cataplexy plus confirmatory studies (CSF hypocretin-1 measurement or nocturnal polysomnogram followed by Multiple Sleep Latency Test), orĬ) CSF hypocretin-1 level < 110 pg/mL (or 1/3 of normal control values). The diagnosis must be confirmed by one of the following:ī) confirmatory sleep studies (nocturnal polysomnogram followed by a Multiple Sleep Latency Test). The daytime sleepiness is not better explained by another sleep disorder, medical condition, or medication use. In narcolepsy without cataplexy, excessive daytime sleepiness must be present almost daily for at least three months, but there is either no history of clear-cut cataplexy or a history of atypical (questionable) cataplexy-like episodes. If a history of clear-cut cataplexy is present, the diagnosis need not be but should be confirmed by one of the following:Ī) measurement of cerebrospinal fluid (CSF) hypocretin-1, orī) nocturnal polysomnography (six hours of sufficient sleep and no other sleep disorders) followed by a Multiple Sleep Latency Test (mean sleep latency ≤ 8 min and ≥ 2 sleep-onset REM periods). Narcolepsy without cataplexy has been a topic of debate since, without clear-cut cataplexy, symptoms of narcolepsy (without cataplexy) may be due to hypersomnia of unknown etiology.įor narcolepsy with cataplexy, excessive daytime sleepiness must be present almost daily for at least three months, along with a history of clear-cut cataplexy. The International Classification of Sleep Disorders-2 (ICSD-2) divides narcolepsy into three categories: narcolepsy with cataplexy, narcolepsy without cataplexy, and secondary narcolepsy, discussed below.
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