title: [Diagnosis and treatment of epilepsy and narcolepsy comorbid].
abstract: OBJECTIVE
  To analyze the clinical diagnosis and treatment process of narcolepsy and epilepsy co-existence, and thereby to improve awareness of such cases.
  
  
  METHODS
  The clinical manifestations of 2 cases were observed, and video-electroencephalogram (VEEG), multiple sleep latency tests (MSLT) were performed. Hypocretin 1 level in cerebrospinal fluid was examined in one case.
  
  
  RESULTS
  The onset of disease of case one was started with epilepsy with myoclonic seizure. After half a year, catalepsy induced by emotion especially laughing and excessive daytime sleepiness appeared. MSLT was positive and hypocretin 1 level decreased. Narcolepsy-cataplexy was definitely diagnosed in this case. Valproate was given and seizure was controlled completely, but the excessive daytime sleepiness was aggravated. Combination of valproate, methylphenidate and clomipramine treatment improved the symptoms of narcolepsy and the patient was still free of epileptic seizures. The onset symptoms of case 2 were catalepsy and excessive daytime sleepiness. MSLT was positive. The treatment was ineffective because of bad compliance. After 2 years, episodes of impairment of consciousness with automatism occurred. VEEG showed slow waves and spikes in right temporal area. Complex partial seizure was determined. Oxcarbazepine was used and then the patients became seizures free, but the symptoms of narcolepsy were still obvious.
  
  
  CONCLUSIONS
  Comorbidity of narcolepsy and epilepsy is a rare phenomenon. Clinical symptoms, predisposing factor, VEEG and MSLT can help diagnosis and differential diagnosis. The antiepileptic drugs might aggravate drowsiness. Based on therapy of epilepsy by using antiepileptic drugs, low dosage of central nervous system stimulants might improve the drowsiness and catalepsy symptoms of narcolepsy.
authors: Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
authors: Zhi-xian
authors: ZX
authors: Yang
authors: Fang
authors: F
authors: Han
authors: Jiong
authors: J
authors: Qin
authors: Email: dr_lxy@sina.com.
authors: Xiao-yan
authors: XY
authors: Liu
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D058256:Brain Waves / Q000502:physiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004831:Epilepsies, Myoclonic / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid; D008297:Male; D009290:Narcolepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D009479:Neuropeptides / Q000134:cerebrospinal fluid; D000068797:Orexins; D017286:Polysomnography; D012894:Sleep Stages / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000697:Central Nervous System Stimulants; C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins