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Narcolepsy: a clinical review
  1. Guy Leschziner
  1. Correspondence to Dr Guy Leschziner, Department of Neurology and Sleep Disorders Centre, Guy's and St Thomas’ NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK; guy.leschziner{at}gstt.nhs.uk

Abstract

Despite the classic tetrad of clinical features that typify it, narcolepsy remains much under-diagnosed, in part, because of the wide spectrum of clinical phenotypes, but also because of its insidious onset, usually in a young person. The median time to diagnosis from first symptoms remains very long, around 10 years in the UK. Conversely, in the specialist setting, it is likely over-diagnosed, largely because of failure to exclude other causes of hypersomnia. There is an over-reliance on a biological marker of the condition, the multiple sleep latency test (MSLT), which, like many tests, has a significant false-positive and false-negative rate. This review aims to discuss some of the difficulties in achieving a diagnosis, interpretation of investigations, differential diagnosis, and appropriate management of patients with narcolepsy.

  • Sleep Disorders

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