Diagnosis of Narcolepsy

For Narcolepsy diagnosis, in some cases a verbal history will be sufficient to diagnose the disorder. Careful questioning of the patient will usually dispel any doubts. Similar questioning of family members who have lived with the patient can provide further confirmation of the diagnosis. The presence of cataplexy is very highly suggestive of narcolepsy. The pervasive influence of the symptoms on all aspects of life make it extremely unlikely the patient and/or the family members could deceive or mislead a physician who has a clear understanding of the syndrome.

If doubts remain the patient should be refered to a sleep centre for polysomnographic testing by professionally trained specialists in the evaluation of sleep disorders. In the sleep centre patients will undergo tests to determine how rapidly they fall asleep. The type of sleep they enter into from consiousness will be recorded. Evidence that they pass directly into REM sleep (see ‘Causes’) is regarded as being positive for narcolepsy.

Testing for the tissue type associated with narcolepsy may be carried out. In the future it is possible that measurement of orexin (hypocretin) levels in the cerebrospinal fluid will become routine.

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