Further Outpatient Care
- Both the primary pediatrician and pediatric neurologist should monitor children with narcolepsy.
- A sleep medicine specialist, if available, also should see the patient regularly.
- Patients should contact narcolepsy support groups.
Prognosis
With proper management and treatment, patients with narcolepsy usually lead meaningful and productive personal and professional lives.
Patient Education
- Advise patients with narcolepsy about driving responsibilities.
- Educate patients, parents, teachers, and other care providers concerning the symptoms, prognosis, and safety precautions.
- For excellent patient education resources, visit eMedicine's Sleep Disorders Center. Also, see eMedicine's patient education article Narcolepsy.
Lin L, Faraco J, Li R, et al. The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene. Cell. Aug 6 1999;98(3):365-76. [Medline].
Chemelli RM, Willie JT, Sinton CM, Elmquist JK, Scammell T, Lee C, et al. Narcolepsy in orexin knockout mice: molecular genetics of sleep regulation. Cell. Aug 20 1999;98(4):437-51. [Medline].
Thannickal TC, Moore RY, Nienhuis R, Ramanathan L, Gulyani S, Aldrich M, et al. Reduced number of hypocretin neurons in human narcolepsy. Neuron. Sep 2000;27(3):469-74. [Medline].
Thannickal TC, Nienhuis R, Siegel JM. Localized loss of hypocretin (orexin) cells in narcolepsy without cataplexy. Sleep. Aug 1 2009;32(8):993-8. [Medline].
Nishino S, Sakurai E, Nevsimalova S, Yoshida Y, Watanabe T, Yanai K. Decreased CSF histamine in narcolepsy with and without low CSF hypocretin-1 in comparison to healthy controls. Sleep. Feb 1 2009;32(2):175-80. [Medline].
Kanbayashi T, Kodama T, Kondo H, Satoh S, Inoue Y, Chiba S. CSF histamine contents in narcolepsy, idiopathic hypersomnia and obstructive sleep apnea syndrome. Sleep. Feb 1 2009;32(2):181-7. [Medline].
Dauvilliers Y, Abril B, Mas E, Michel F, Tafti M. Normalization of hypocretin-1 in narcolepsy after intravenous immunoglobulin treatment. Neurology. Oct 20 2009;73(16):1333-4. [Medline].
Guilleminault C, Pelayo R. Narcolepsy in prepubertal children. Ann Neurol. Jan 1998;43(1):135-42. [Medline].
Melberg A, Hetta J, Dahl N, et al. Autosomal dominant cerebellar ataxia deafness and narcolepsy. J Neurol Sci. Dec 1995;134(1-2):119-29. [Medline].
Vossler DG, Wyler AR, Wilkus RJ, et al. Cataplexy and monoamine oxidase deficiency in Norrie disease. Neurology. May 1996;46(5):1258-61. [Medline].
Rogers AE, Aldrich MS, Lin X. A comparison of three different sleep schedules for reducing daytime sleepiness in narcolepsy. Sleep. Jun 15 2001;24(4):385-91. [Medline].
Fry JM. Treatment modalities for narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S43-8. [Medline].
The Nuvigil website. Available at www.nuvigil.com. Accessed 12/8/2009.
Xyrem Web site. Available at www.xyrem.com.
Lockrane B, Bhatia P, Gore R. Successful treatment of narcolepsy and cataplexy: A review. Can Respir J. May-Jun 2005;12(4):225-7. [Medline].
Abad VC, Guilleminault C. Review of rapid eye movement behavior sleep disorders. Curr Neurol Neurosci Rep. Mar 2004;4(2):157-63. [Medline].
Aldrich MS. Diagnostic aspects of narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S2-7. [Medline].
Aldrich MS, Chervin RD, Malow BA. Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy. Sleep. Aug 1997;20(8):620-9. [Medline].
Bassetti C, Aldrich MS, Quint DJ. MRI findings in narcolepsy. Sleep. Aug 1997;20(8):630-1. [Medline].
Benbadis SR. Daytime sleepiness: when is it normal? When to refer?. Cleve Clin J Med. Nov-Dec 1998;65(10):543-9. [Medline].
Benbadis SR. Effective treatment of narcolepsy with codeine in a patient receiving hemodialysis. Pharmacotherapy. May-Jun 1996;16(3):463-5. [Medline].
Benbadis SR, Mascha E, Perry MC, et al. Association between the Epworth sleepiness scale and the multiple sleep latency test in a clinical population. Ann Intern Med. Feb 16 1999;130(4 Pt 1):289-92. [Medline]. [Full Text].
Blouin AM, Thannickal TC, Worley PF, Baraban JM, Reti IM, Siegel JM. Narp immunostaining of human hypocretin (orexin) neurons: loss in narcolepsy. Neurology. Oct 25 2005;65(8):1189-92. [Medline].
Choo KL, Guilleminault C. Narcolepsy and idiopathic hypersomnolence. Clin Chest Med. Mar 1998;19(1):169-81. [Medline].
Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. Feb 10 2007;369(9560):499-511. [Medline].
Dauvilliers Y, Baumann CR, Carlander B, Bischof M, Blatter T, Lecendreux M, et al. CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions. J Neurol Neurosurg Psychiatry. Dec 2003;74(12):1667-73. [Medline].
Douglas NJ. The psychosocial aspects of narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S27-30. [Medline].
Eguchi T, Nakase H, Tsujimoto S, et al. Serial change of cerebral blood flow and intracranial pressure in status epilepticus. Jpn J Psychiatry Neurol. Jun 1992;46(2):546-8. [Medline].
Gerashchenko D, Kohls MD, Greco M, et al. Hypocretin-2-saporin lesions of the lateral hypothalamus produce narcoleptic-like sleep behavior in the rat. J Neurosci. Sep 15 2001;21(18):7273-83. [Medline]. [Full Text].
Gregori J, Ortuno J, Ruiz Rivas JL, Arenas M. [Brucellosis and portal thrombosis]. Rev Esp Enferm Dig. Sep 1990;78(3):187-8. [Medline].
Guilleminault C, Heinzer R, Mignot E, Black J. Investigations into the neurologic basis of narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S8-15. [Medline].
Han F, Chen E, Wei H, et al. Childhood narcolepsy in North China. Sleep. May 1 2001;24(3):321-4. [Medline].
Larrosa O, de la Llave Y, Bario S, et al. Stimulant and anticataplectic effects of reboxetine in patients with narcolepsy: a pilot study. Sleep. May 1 2001;24(3):282-5. [Medline].
Longstreth WT Jr, Koepsell TD, Ton TG, Hendrickson AF, van Belle G. The epidemiology of narcolepsy. Sleep. Jan 1 2007;30(1):13-26. [Medline].
Macleod S, Ferrie C, Zuberi SM. Symptoms of narcolepsy in children misinterpreted as epilepsy. Epileptic Disord. Mar 2005;7(1):13-7. [Medline].
Maeda M, Tamaoka A, Hayashi A, et al. [A case of HLA-DR2, DQw1 negative post-traumatic narcolepsy]. Rinsho Shinkeigaku. Jul 1995;35(7):811-3. [Medline].
Maret S, Tafti M. Genetics of narcolepsy and other major sleep disorders. Swiss Med Wkly. Nov 19 2005;135(45-46):662-5. [Medline].
Mignot E. Genetic and familial aspects of narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S16-22. [Medline].
Mignot E. Genetics of narcolepsy and other sleep disorders. Am J Hum Genet. Jun 1997;60(6):1289-302. [Medline].
Mignot E, Lammers GJ, Ripley B, Okun M, Nevsimalova S, Overeem S, et al. The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Arch Neurol. Oct 2002;59(10):1553-62. [Medline].
Naumann A, Daum I. Narcolepsy: Pathophysiology and neuropsychological changes. Behav Neurol. 2003;14(3,4):89-98. [Medline].
Nishino S, Ripley B, Overeem S, et al. Hypocretin (orexin) deficiency in human narcolepsy [letter] [see comments]. Lancet. Jan 1 2000;355(9197):39-40. [Medline].
Nishino S, Ripley B, Overeem S, Nevsimalova S, Lammers GJ, Vankova J, et al. Low cerebrospinal fluid hypocretin (Orexin) and altered energy homeostasis in human narcolepsy. Ann Neurol. Sep 2001;50(3):381-8. [Medline].
Overeem S, Black JL 3rd, Lammers GJ. Narcolepsy: immunological aspects. Sleep Med Rev. Apr 2008;12(2):95-107. [Medline].
Pakola SJ, Dinges DF, Pack AI. Review of regulations and guidelines for commercial and noncommercial drivers with sleep apnea and narcolepsy. Sleep. Nov 1995;18(9):787-96. [Medline].
Pelin Z, Guilleminault C, Risch N, Grumet FC, Mignot E. HLA-DQB1*0602 homozygosity increases relative risk for narcolepsy but not disease severity in two ethnic groups. US Modafinil in Narcolepsy Multicenter Study Group. Tissue Antigens. Jan 1998;51(1):96-100. [Medline].
Peterson PC, Husain AM. Pediatric narcolepsy. Brain Dev. Mar 27 2008;[Medline].
Plazzi G, Serra L, Ferri R. Nocturnal aspects of narcolepsy with cataplexy. Sleep Med Rev. Apr 2008;12(2):109-28. [Medline].
Servan J, Marchand F, Garma L, et al. [Narcolepsy disclosing neurosarcoidosis]. Rev Neurol (Paris). Apr 1995;151(4):281-3. [Medline].
Silber MH, Krahn LE, Olson EJ, Pankratz VS. The epidemiology of narcolepsy in Olmsted County, Minnesota: a population-based study. Sleep. Mar 15 2002;25(2):197-202. [Medline].
US Modafinil in Narcolepsy Multicenter Study Group. Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy. Neurology. Mar 14 2000;54(5):1166-75. [Medline].
Vendrame M, Havaligi N, Matadeen-Ali C, Adams R, Kothare SV. Narcolepsy in children: a single-center clinical experience. Pediatr Neurol. May 2008;38(5):314-20. [Medline].
[Best Evidence] Vignatelli L, D'Alessandro R, Candelise L. Antidepressant drugs for narcolepsy. Cochrane Database Syst Rev. Jul 20 2005;CD003724. [Medline].
Wise MS. Childhood narcolepsy. Neurology. Feb 1998;50(2 Suppl 1):S37-42. [Medline].

