Cyclic hypersomnolence with symptoms of narcolepsy with cataplexy: An unusual presentation of probable immune-mediated encephalitis

Rafer Willenberg; Jonathan D Bui

doi:10.1016/j.ensci.2018.01.003

Cyclic hypersomnolence with symptoms of narcolepsy with cataplexy: An unusual presentation of probable immune-mediated encephalitis

eNeurologicalSci. 2018 Jan 28:10:26-27. doi: 10.1016/j.ensci.2018.01.003. eCollection 2018 Mar.

Authors

Rafer Willenberg^{1

2}, Jonathan D Bui^{1

3}

Affiliations

¹ Department of Neurosciences, University of California, San Diego 9500 Gilman Drive #0935, La Jolla, CA 92093, USA.
² Department of Neurology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., A6600, Los Angeles, CA 90048, USA.
³ Division of Child Neurology, Rady Children's Hospital, 3020 Children's Way, MC 5009, San Diego, CA 92123, USA.

Abstract

We report a case of probable encephalitis presenting as narcolepsy with cataplexy, but with cyclical exacerbation and cognitive difficulties. Our patient continued to worsen despite treatment for narcolepsy and later was thought to have an immune-mediated encephalopathy. Treatment with intravenous gamma immunoglobulin (IVIG) led to complete recovery. Cyclic symptoms of narcolepsy with cataplexy are thus one presentation of probable immune-mediated encephalitis.

Keywords: Cyclic; Encephalopathy; Hypersomnolence; IVIG; Immunotherapy; Narcolepsy; Seronegative encephalitis.

Publication types

Case Reports