Lesson of the week: Narcolepsy mistaken for epilepsy

doi:10.1136/bmj.322.7280.216

BMJ 2001;322:216-218 ( 27 January )

Clinical review

Lesson of the week

Narcolepsy mistaken for epilepsy

Narcolepsy is common: its cardinal symptoms can give rise to confusion with epilepsy

Adam Zeman, consultant neurologist ^a, Neil Douglas, professor ^b, Rebecca Aylward, locum consultant neurologist ^c.

^a Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH2 2XU, ^b Sleep Laboratory, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, ^c Epilepsy Clinic, Falkirk Royal Infirmary, Falkirk FK1 5QE

Correspondence to: A Zeman az@skull.dcn.ed.ac.uk

The first 150 words of the full text of this article appear below.

Narcolepsy is a distinctive but underdiagnosed disorder of sleep and waking. Its cardinal manifestations are: (a) excessivedaytime sleepiness, with a tendency to nap repeatedly throughthe day; (b) cataplexy, a loss of muscle tone triggered by emotion,causing immobility for seconds to minutes; (c) hypnagogic hallucinations,vivid visual or auditory phenomena, experienced at the onset ofsleep; and (d) sleep paralysis, an inability to move on firstawakening.¹

When a patient describes all these symptoms the diagnosis should be straightforward. Diagnostic difficulty arises when patientspresent with isolated symptoms, or if their story suggests somemore familiar diagnosis. We report on three patients recentlyencountered in whom narcolepsy was initially mistaken for epilepsy.Indeed, Gelineau, the French physician who coined the term "narcolepsy"in 1880, was at pains to distinguish his novel disorder of sleep(narco from the Greek for "sleep" and . . . [Full text of this article]

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