Narcolepsy Patient Presenting as Drop Attack without Emotional Triggering and Subjective Sleepiness

Abstract

Narcolepsy type I is characterized by excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic hallucination, and fragmented night-time sleep. Although diagnosis is based on clinical history, it needs to be confirmed by nocturnal polysomnography, followed by a daytime multiple sleep latency test (MSLT). However, EDS, which is the central symptom of the narcolepsy, is unspecific and there could be a disparity between subjective daytime sleepiness and objective daytime sleepiness measured by MSLT. Also, cataplexy, which is the exclusive symptom of narcolepsy, has a wide phenotypical variability and is triggered by a range of stimuli, even without definite identifiable emotional trigger. We report an unusual narcolepsy patient with spontaneous cataplexy, without an identifiable trigger and subjective daytime sleepiness.

Keywords

• Cataplexy
• Narcolepsy
• Excessive daytime sleepiness
• Subjective sleepiness