[Narcolepsy in childhood and adolescence: symptoms, diagnosis, and therapy. A case report].
Narcolepsy is a rare, multifactorial disease of the hypothalamus characterized by its leading symptoms of excessive daytime sleepiness and cataplexy. Sleep-EEG and a HLA-DR-genotype serve to secure the diagnosis. We report here on a 14-year-old girl suffering from anxieties, depression, school refusal, social withdrawal as well as very frequent attacks of sleep during the day and cataplexy. Currently, there is no approved drug for children and adolescents suffering from narcolepsy. Our patient benefited significantly and quickly from an off-label treatment with methylphenidate in combination with psychoeducation, cognitive behavioral therapy, and family therapy. Narcolepsy is a very rare but probably underestimated differential diagnosis applied to unclear daytime sleepiness, anxieties, or depression in childhood and adolescence. Both the key symptoms and the comorbid symptoms improve significantly under treatment with stimulants, albeit at a higher dosage.
1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ludwigshafen a. Rh., Deutschland.
Jochen
J
Gehrmann
1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ludwigshafen a. Rh., Deutschland.
Dominik
D
Siegler
1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ludwigshafen a. Rh., Deutschland.
Evelin
E
Ignacy
1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ludwigshafen a. Rh., Deutschland.
Inga
I
Reimer
D000293:Adolescent; D002375:Catalepsy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005196:Family Therapy; D005260:Female; D005838:Genotype; D006684:HLA-DR Antigens / Q000235:genetics; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use; D009290:Narcolepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010353:Patient Education as Topic; D017286:Polysomnography
D006684:HLA-DR Antigens; D008774:Methylphenidate
Methylphenidat; autoimmunity; cataplexy; daytime sleepiness; methylphenidate; narcolepsy