Child Neurology: A Case Series of Heterogeneous Neuropsychiatric Symptoms and Outcome in Very Early-Onset Narcolepsy Type 1

Marco Veneruso; Fabio Pizza; Elena Finotti; Giulia Amore; Stefano Vandi; Marco Filardi; Elena Antelmi; Lino Nobili; Alessandra Cassio; Andrea Pession; Giuseppe Plazzi

doi:10.1212/WNL.0000000000200666

Child Neurology: A Case Series of Heterogeneous Neuropsychiatric Symptoms and Outcome in Very Early-Onset Narcolepsy Type 1

Neurology. 2022 Jun 7;98(23):984-989. doi: 10.1212/WNL.0000000000200666. Epub 2022 Apr 6.

Authors

Affiliations

¹ From the Department of Neurosciences (M.V., L.N.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova; IRCCS Istituto Delle Scienze Neurologiche di Bologna (M.V., F.P., D., G.P.); Department of Biomedical and Neuromotor Sciences (F.P., G.A., D.), University of Bologna; Department of Rehabilitation, Child and Adolescent Neuropsychiatry Unit (E.F.), ULSS 6, Vicenza; Department of Basic Medicine (M.F.), Neuroscience and Sense Organs, University Aldo Moro Bari; Center for Neurodegenerative Diseases and the Aging Brain (M.F.), University of Bari Aldo Moro -A.O. Pia Fondazione Cardinale G. Panico, Tricase; Neurology Unit (E.A.), Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona; Child Neuropsychiatry Unit (L.N.), IRCCS Istituto G. Gaslini, Genova; Department of Medical and Surgical Sciences (A.C., A.P.), University of Bologna; IRCCS S.Orsola-Malpighi Hospital (A.C., A.P.); and Department of Biomedical (G.P.), Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
² From the Department of Neurosciences (M.V., L.N.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova; IRCCS Istituto Delle Scienze Neurologiche di Bologna (M.V., F.P., D., G.P.); Department of Biomedical and Neuromotor Sciences (F.P., G.A., D.), University of Bologna; Department of Rehabilitation, Child and Adolescent Neuropsychiatry Unit (E.F.), ULSS 6, Vicenza; Department of Basic Medicine (M.F.), Neuroscience and Sense Organs, University Aldo Moro Bari; Center for Neurodegenerative Diseases and the Aging Brain (M.F.), University of Bari Aldo Moro -A.O. Pia Fondazione Cardinale G. Panico, Tricase; Neurology Unit (E.A.), Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona; Child Neuropsychiatry Unit (L.N.), IRCCS Istituto G. Gaslini, Genova; Department of Medical and Surgical Sciences (A.C., A.P.), University of Bologna; IRCCS S.Orsola-Malpighi Hospital (A.C., A.P.); and Department of Biomedical (G.P.), Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. giuseppe.plazzi@isnb.it.

PMID: 35387850
DOI: 10.1212/WNL.0000000000200666

Abstract

Narcolepsy type 1 is a central disorder of hypersomnolence characterized by excessive daytime sleepiness, cataplexy (i.e., sudden loss of muscle tone during wakefulness triggered by emotions), and REM sleep-related manifestations that can present with a peculiar phenotype when arising at a pediatric age. Several features of childhood-onset narcolepsy type 1 are also common in neuropsychiatric conditions; discrete neuropsychiatric comorbidity has also been demonstrated. Here, we report on 3 children with very early narcolepsy type 1. All 3 patients had psychiatric features at the time of symptom onset coupled with peculiar motor disturbances. The course of narcolepsy symptoms also paralleled neuropsychiatric symptoms, suggesting a possible intrinsic link between sleep and psychological features. Multidisciplinary management is mandatory for pediatric narcolepsy type 1 since prompt disease management addressing neuropsychiatric symptoms could lead to better clinical outcomes and quality of life.

MeSH terms

Cataplexy* / diagnosis
Child
Disorders of Excessive Somnolence* / diagnosis
Humans
Narcolepsy* / diagnosis
Narcolepsy* / therapy
Neurology*
Quality of Life