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Narcolepsy

Waiz Wasey, MD and Taaha S. Rafi, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Narcolepsy is a chronic incurable neurologic sleep disorder mainly characterized by excessive daytime sleepiness (EDS) and may be associated with cataplexy (sudden loss of muscle con...

DIAGNOSIS

HISTORY

  • Classic pentad of EDS, cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations, and disrupted nocturnal sleep (five most common symptoms): Only 10–20% have all five.

  • EDS ...

TREATMENT

GENERAL MEASURES

  • Medications do not cure, but the goal is to minimize EDS and cataplectic episodes.

  • Proper sleep hygiene and a regular sleep schedule.

  • Well-timed 15- to 20-minute naps may be he...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitoring using scoring tools to gauge treatment effectiveness and symptom control

  • Frequent BP checks and regular follow-ups (approximately ever...

REFERENCES

1
Zhang J, Han F. Sleepiness in narcolepsy. Sleep Med Clin.  2017;12(3):323–330.
2
Calik MW. Update on the treatment of narcolepsy: clinical efficacy of pitolisant. Nat Sci Sleep.  2...

CODES

ICD10

  • G47.429 Narcolepsy in conditions classified elsewhere w/o cataplexy

  • G47.411 Narcolepsy with cataplexy

  • G47.419 Narcolepsy without cataplexy

  • G47.421 Narcolepsy in conditions classified elsewhere...

CLINICAL PEARLS

  • Narcolepsy is an incurable, REM disorder, with 15 years of symptoms before a diagnosis is made.

  • The classic tetrad includes EDS, cataplexy, sleep paralysis, and hypnagogic hallucination...

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