1123 A RARE CASE OF LATE PRESENTATION OF POST TRAUMATIC NARCOLEPSY

• Published in: Sleep (New York, N.Y.) N.Y.), 2018-04, Vol.41 (suppl_1), p.A416-A416
• Main Authors: Adejorin, Oluwaseyi D, Ochoa, Jose, Singh, Supriya
• Format: Article
• Language: English
• Subjects: Post traumatic stress disorder; Sleep deprivation; Sleep disorders; Traumatic brain injury
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsy063.1122

Abstract Introduction Narcolepsy with cataplexy is a serious disabling sleep disorder characterized by excessive daytime sleepiness, abnormal rapid eye movement and sleep attacks. The development of human narcolepsy involves environmental factors acting on specific genetic background. One of such environmental factor is traumatic brain injury. The patient in the case report had late presentation of narcolepsy several years after traumatic brain injury Report of Case 39-year-old Male presented with 1 year history of progressively worsening excessive daytime sleepiness including while driving. Episodes were characterized by sleep attacks and sleep paralysis. No associated cataplexy and no hallucination. Patient also reported history of traumatic brain injury he sustained after falling off motorbike with extensive hospital stay but with full recovery 12 years prior to sleepiness symptoms. Physical Examination findings were normal with exception of postsurgical head scar He subsequently had attended polysomnogram which showed AHI 5.3 with 02 nadir 88% and no other abnormal findings on sleep study. Patient was subsequently started on AutoCPAP with no improvement in sleepiness symptoms reported with Epworth sleepiness scale 20. Overnight Polysomnogram with next day Multiple sleep latency test was then performed which showed 4 SOREMPS and mean sleep time latency of 4.5 minutes confirmatory of narcolepsy without cataplexy Conclusion Hypersomnia can result when areas involving the maintenance of wakefulness are injured such as rostral pons, caudal midbrain and the thalamus. Irshad et al (2005) reviewed previous reported 20 cases of posttraumatic narcolepsy with report indicating duration of narcolepsy symptom onset from the index event varied between few hours to 18 months. The rarity of post traumatic narcolepsy in this case is due to the late presentation of Narcolepsy several years after traumatic brain injury. Our patient was started on modafinil