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Narcolepsy in children

Suresh Kotagal, MD
Section Editors
Thomas E Scammell, MD
Ronald D Chervin, MD, MS
Deputy Editor
April F Eichler, MD, MPH


Narcolepsy is a chronic neurologic disorder characterized by excessive and irresistible sleepiness, cataplexy, hypnagogic hallucinations (vivid dreams at sleep onset), and sleep paralysis (a momentary inability to move the body as one is drifting off to sleep). Although relatively rare in general, it is one of the more common causes of disabling daytime sleepiness beginning in adolescence or early adulthood.

Narcolepsy can present in children as young as five or six years of age, and delays in diagnosis are common. Early-onset narcolepsy has some unique clinical features compared with later onset cases, including cataplexy with prominent oculobuccofacial involvement and daytime sleepiness manifesting primarily as habitual napping or irritability and hyperactivity.

This topic will review the clinical features, diagnosis, and management of narcolepsy in children. Narcolepsy in adults is reviewed separately. (See "Clinical features and diagnosis of narcolepsy in adults" and "Treatment of narcolepsy in adults".)


The International Classification of Sleep Disorders, Third Edition (ICSD-3), recognizes two forms of narcolepsy [1]:

Type 1 (previously called narcolepsy with cataplexy) – Patients with narcolepsy type 1 generally show cataplexy along with sleepiness at the very onset of the disorder or within the first several years of the onset of sleepiness. The underlying pathophysiology is a deficiency of central nervous system hypocretin (orexin), which is a peptide essential for maintaining alertness. (See 'Pathophysiology' below.)

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Literature review current through: Nov 2017. | This topic last updated: Oct 03, 2017.
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