Narcolepsy is characterized by the classic tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. Narcolepsy is a chronic disease of the central nervous system. Excessive daytime sleepiness , loss of muscle tone (cataplexy),distorted perceptions (hypnagogic hallucinations), and inability to move or talk (sleep paralysis).Narcolepsy usually begins in teenagers or young adults and affects both sexes equally.

 

The characteristic feature of this syndrome is day sleep attacks, weakness with laughter, sleep paralysis, hypnagogic hallucinations. But the main feature is excessive daytime sleepiness and collapse with laughter or emotion. It is very common and disabling. This disease is usually lifelong but does not affect the lifespan. It is classified as mild, moderate and severe.

 

Symptoms:

Excessive day time sleeping (narcolepsy)

Cataplexy: It is loss of muscle tone with sudden intense emotion including anger and surprise as well as laughter.

Sleep paralysis: It is inability to move during the transition between sleep and wakefulness.

Insomnia in the night time: In the night the sleep are light, non refreshing with frequent arousals. Patient will wake over 300 times each night.

Motor dyscontrol during sleep like sleep talking, sleep walking and muscle jerking.

Hypnagogic hallucinations: It is a form of mental experience with visual decorative or fanciful patterns, distinct from true dream mentation and occurs at the onset of sleep.

Vivid dreams which are frequent, egocentric, scene shifting and often frightening and the dreams occur around 3-4 times a week.

 

Diagnosis:

• Medical history.
• Multiple sleep latency testing.
• Various scales like sleepiness scale, Ullanlinna narcolepsy scale, cataplexy rating scale etc are used to diagnose neuroleptic syndrome.
• Polysomnography.
• HLA typing. 

Treatment:

Central stimulant drugs like dexamphetamine, methyphenidate, mazindol, modafinil

Serotonin re uptake inhibitors like clomipramine and fluoxetine is used for cataplexy.

The combination of both of these drugs are also tried.