Very late onset narcolepsy type 1: a case report and review of the literature
Journal of Clinical Sleep Medicine (JCSM) December 31, 2024 J. Martens, M. V. D. van den Bossche
Narcolepsy type 1 can first appear as late as the sixth decade of life, as illustrated by the case of a 64-year-old woman whose main symptom was new-onset visual hallucinations. Diagnosis was confirmed by measuring low orexin (hypocretin-1) levels in cerebrospinal fluid. The authors argue that clinicians should consider narcolepsy type 1 as a possible, though rare, diagnosis in older adults presenting with new neuropsychiatric symptoms such as visual hallucinations, even though the disorder typically begins in the second or third decade.