Obstructive sleep apnoea syndrome presenting in a neurology outpatient clinic

The various neurological guises in which obstructive sleep apnoea syndrome (OSAS) may present are illustrated by reporting four previously undiagnosed patients seen by one consultant neurologist in general neurological outpatient clinics. Presenting features were episodes of loss of consciousness (2), stroke, and excessive daytime somnolence; morning headache and cognitive decline were also observed. Two patients had been involved in road traffic accidents. Diagnoses suggested by the referring doctors included epilepsy, stroke and narcolepsy. Since OSAS is associated with increased morbidity and mortality, yet is frequently amenable to treatment, neurologists should be familiar with the heterogeneous presentations of this condition.