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"Oh My Sleeping Child" … Narcolepsy Type 1 in a 22-Month-Old Boy

Barbra Giourgas1, Alexandra Morgan2, Sonal Bhatia1

  • 1Department of Pediatrics, Division of Pediatric Neurology, Shawn Jenkins Children's Hospital and Medical University of South Carolina, Charleston, SC, USA.

Child Neurology Open
|May 20, 2024
PubMed

Insights

Diagnosing narcolepsy in very young children can be challenging. Measuring hypocretin-1 (orexin) levels in cerebrospinal fluid (CSF) offers a viable method for diagnosing narcolepsy type 1 in infants too young for polysomnography with multiple sleep latency testing (PSG with MSLT).

Area of Science:

  • Neurology
  • Pediatrics
  • Sleep Medicine

Background:

  • Pediatric narcolepsy presents diagnostic challenges, typically requiring clinical evaluation, polysomnography with multiple sleep latency testing (PSG with MSLT), and cerebrospinal fluid (CSF) hypocretin-1 (orexin) levels.
  • Narcolepsy type 1 diagnosis in very young children is difficult due to limitations of standard testing methods.

Observation:

  • A 22-month-old boy presented with excessive daytime sleepiness (EDS) and frequent falls.
  • This case highlights the potential for narcolepsy in infants younger than typically diagnosed.

Findings:

  • The child was diagnosed with narcolepsy type 1 using CSF hypocretin-1 (orexin) levels.
  • This method proved effective for diagnosing narcolepsy in a patient too young for PSG with MSLT.

Implications:

  • CSF hypocretin-1 (orexin) levels can be a crucial diagnostic tool for narcolepsy type 1 in pre-school-aged children.
  • Early diagnosis and intervention in pediatric narcolepsy can significantly improve cognitive development and reduce long-term complications.
  • This case report suggests narcolepsy may occur earlier than previously documented, necessitating broader diagnostic considerations.

Keywords:
excessive daytime sleepinesshypocretin-1(orexin)pediatric narcolepsytoddler

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