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Narcolepsy Type 1 — SCE Neurology MCQ

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HardSleep DisordersNarcolepsy Type 1SCE Neurology

A man has irresistible daytime sleep episodes, emotion-triggered bilateral knee buckling, hypnagogic hallucinations and sleep paralysis. He has maintained an adequate sleep schedule and has no clinical features of OSA. What investigation sequence best confirms the suspected disorder?

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Correct answer: B — Overnight polysomnography followed by a properly prepared multiple sleep latency test

Narcolepsy is confirmed with a properly prepared MSLT, but the test should follow overnight polysomnography and adequate prior sleep so that untreated OSA, sleep deprivation and other confounders are excluded. Cataplexy strongly supports type 1 narcolepsy; screening scales cannot establish the diagnosis.

Reference: European guideline and expert statements on the management of narcolepsy in adults and children: https://pubmed.ncbi.nlm.nih.gov/34173695/