Fast Five Quiz: Narcolepsy

Heidi Moawad, MD


February 06, 2023

While signs of narcolepsy most commonly begin to develop between 10 and 25 years, the lag between symptom onset and formal diagnosis is often significantly delayed, averaging 5-15 years. Globally, narcolepsy is considered a significantly underdiagnosed and misdiagnosed condition.

Symptoms of cataplexy may be misdiagnosed as a manifestation of a seizure disorder. Cataplexy can also be mistaken for a transient ischemic attack when facial muscle tone is involved. In addition, EDS can be misdiagnosed initially as depression. Patients with obesity may be labeled as having obstructive sleep apnea episodes to account for their daytime sleepiness. Finally, attention deficit hyperactivity disorder is a common misdiagnosis among children with narcoleptic symptoms. In the pediatric population, the condition can manifest as hyperactivity or aggression.

The exact cause of the hypocretin destruction behind narcolepsy type 1 lacks formal consensus, but it has been hypothesized that the condition is a T-cell-mediated autoimmune disease targeting these hypocretin neurons. While symptoms do not occur in series of flare and remission as with some other inflammatory conditions, symptoms of narcolepsy can wax and wane.

Learn more about narcolepsy.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.