Cataplexy Mistaken for Seizures in a Patient With Undiagnosed Narcolepsy Type I.
Publication/Presentation Date
4-1-2024
Abstract
Narcolepsy Type 1 is a sleep disorder, with cataplexy as its cardinal feature, characterized by sudden decrease or loss of muscle tone triggered by strong emotions. Cataplexy can be misdiagnosed as epileptic seizures given its clinical similarity to atonic seizures. The low prevalence of the disease added another layer of complexity in providing timely and accurate diagnosis. We report a case of a young man with recurrent episodes of falling and an inability to respond, initially misinterpreted as epileptic seizures due to findings in routine electroencephalography (EEG). Anti-seizure medications were ineffective, and subsequent ambulatory EEG revealed no epileptic activity during events. A detailed history uncovered symptoms of cataplexy and daytime sleepiness, leading to the correct diagnosis of narcolepsy type I confirmed by polysomnogram (PSG) and mean sleep latency test (MSLT). Discontinuation of anti-seizure medications and treatment with venlafaxine successfully resolved cataplexy. The case highlights the importance of a thorough clinical history in distinguishing cataplexy from seizures, as well as the caution against relying solely on EEG findings for epilepsy diagnosis. Ambulatory EEG can help exclude epileptic events, and PSG with MSLT are necessary to confirm narcolepsy type I.
Volume
16
Issue
4
First Page
57540
Last Page
57540
ISSN
2168-8184
Published In/Presented At
Rehim, E. D., & Vendrame, M. (2024). Cataplexy Mistaken for Seizures in a Patient With Undiagnosed Narcolepsy Type I. Cureus, 16(4), e57540. https://doi.org/10.7759/cureus.57540
Disciplines
Medicine and Health Sciences
PubMedID
38707044
Department(s)
Department of Medicine, Department of Medicine Fellows and Residents, Department of Medicine Faculty
Document Type
Article