NARCOLEPSY IN PREPUBERTAL CHILDREN

Narcolepsy was diagnosed in 51 children (29 boys). The age range was 2 .1 to 11.8 years (mean, 7.9 +/- 3.1 years). A mean of three referrals was made before narcolepsy was considered. In 10 children, cataplexy w as the presenting symptom. Thirty-eight children acknowledged sleep pa ralysis and 30 acknowledged hypnagogic hallucinations. All children ha d sleep studies; 31 exhibited rapid eye movement at sleep onset. The m ean sleep latency was 1.5 minutes +/- 39 seconds on the Multiple Sleep Latency Test. ALL children had at least two sleep-onset rapid eye mov ement sleep episodes in this test. Forty-six children were HLA class I I-positive for DQwG, and 45 were also positive for DRw15. Thirty (65%) families refused referrals to support and counseling groups. Teachers often refused to acknowledge a medical problem. During followup, all children presented at least once with depressive symptoms in reaction to their syndrome. Narcolepsy should be considered when evaluating chi ldren with behavioral and depressive symptoms.