Differential consideration
Narcolepsy
G47.419Sleep-Wake
Why consider it
cataplexy, sleep paralysis, hypnagogic hallucinations, low hypocretin-1; MSLT
Criteria and features to review
- A. Recurrent periods of irrepressible need to sleep, lapsing into sleep, or napping within same day, for ≥3 months; ≥1 of: cataplexy (brief episodes of bilateral muscle tone loss) ≥few times/month; hypocretin deficiency (CSF hypocretin-1 ≤110 pg/mL); REM sleep latency ≤15 min on MSLT (or mean sleep latency ≤8 min with ≥2 sleep-onset REM periods)
Questions to clarify
- Which documented criteria and exclusions are met for each possibility?
- What timeline, course, and functional change best distinguishes the alternatives?
- Are substance, medication, medical, developmental, and contextual explanations adequately assessed?