Narcolepsy Type 2 with a History of Self-Limited Epilepsy: A Case Report

ABSTRACT

Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness and abnormal manifestations of rapid eye movement sleep on polysomnography with multiple sleep latency testing (MSLT). Its co-occurrence with epilepsy is uncommon; both disorders may share overlapping clinical features that can lead to diagnostic confusion, particularly in pediatric patients. Like previously reported cases of epilepsy coexisting with narcolepsy type 1, our case demonstrates that also narcolepsy type 2 may develop in individuals with a history of epilepsy. We report on a 15-year-old boy with a history of self-limited epilepsy before age 9 who presented with excessive daytime sleepiness and sleep paralysis started at 12-year age. Polysomnography with MSLT confirmed narcolepsy type 2. Treatment with modafinil and sleep hygiene significantly improved his symptoms. This clinical case and a few clinical cases described in the literature about the co-occurrence of narcolepsy and epilepsy may highlight the presence of some overlapping neurophysiological mechanisms between narcolepsy and epilepsy, the importance of instrumental sleep studies, and the correct recognition of similar clinical signs. To the best of our knowledge this is the first case to report development of narcolepsy in a patient with a history of self-limited epilepsy.