title: Misleading hallucinations in unrecognized narcolepsy.
abstract: OBJECTIVE
  To describe psychosis-like hallucinatory states in unrecognized narcolepsy.
  
  
  METHODS
  Two patients with hypnagogic/hypnapompic hallucinations are presented.
  
  
  RESULTS
  Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy.
  
  
  CONCLUSIONS
  We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.
authors.affiliation: Department of Neurology, National Institute of Psychiatry and Neurology, Budapest, Hungary. szucsan@bakats.tvnet.hu
authors.forename: A
authors.initials: A
authors.lastname: Szucs
authors.forename: J
authors.initials: J
authors.lastname: Janszky
authors.forename: A
authors.initials: A
authors.lastname: Holló
authors.forename: G
authors.initials: G
authors.lastname: Migléczi
authors.forename: P
authors.initials: P
authors.lastname: Halász
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000150:complications* / Q000175:diagnosis*; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D019529:Sexuality