DIAGNOSING NARCOLEPSY THROUGH THE SIMULTANEOUS CLINICAL AND ELECTROPHYSIOLOGIC ANALYSIS OF CATAPLEXY

Objective: To demonstrate the utility of accurate clinical and electro encephalographic characterization of provoked cataplexy spells in the diagnosis of narcolepsy. Methods: Four individuals, three with suspect ed and one with known narcolepsy, were clinically assessed during spli t-screen, video polysomnographic monitoring sessions after cataplectic events were induced by emotional provocation. Results: The subjects e xperienced a total of nine cataplectic-like events, one occurring spon taneously (sleep paralysis) in association with a hypnagogic hallucina tion. During all events, the patients appeared to be sleeping with pol ysomnographic rapid eye movement sleep patterns, but when questioned t hey were able to give appropriate verbal responses. The diagnosis of n arcolepsy was substantiated in all cases using standard overnight poly somnograms and multiple sleep latency tests. Conclusion: The diagnosis of narcolepsy can be greatly enhanced by documenting cataplexy with t horough clinical assessment and demonstration of typical rapid eye mov ement sleep patterns during provoked spells in the course of polysomno graphic monitoring sessions.