Characteristics of narcolepsy in childhood

Narcolepsy is a rare disorder with brief daytime sleep periods, transient loss of muscle tone in emotional situations (cataplexy), dream mentation during short periods of sleep (hypnagog hallucinations), and transient inability to move on waking (sleep paralysis), affecting only 2-3000 people in Hungary. Despite its characteristic symptoms, it is difficult to recognise the disease and there is often a delay of decades before a correct diagnosis and hence effective therapy. Cases with a childhood onset require special attention, as the classic complaints mentioned above are accompanied by a number of other symptoms (e.g., extrapyramidal movement disorder-like events, etc.), and the complaints are much more complex. The presentation of some of the classic symptoms, such as cataplexy, is also different from that in adulthood. They make recognition very difficult. The wide range of complaints and symptoms explain diagnostic errors and delays. In the absence of a real pathology, patients are often treated with diagnoses of various neurological and psychiatric disorders. Inappropriate treatment also negatively affects the child's academic development, social interactions, career choice, daily life and quality of life. In this summary, we describe the classical features of narcolepsy, the different symptoms, pathophysiology, differential diagnosis and consequences of non-treatment in childhood cases, diagnostic criteria and therapeutic options.