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Very late onset narcolepsy type 1: a case report and review of the literature

J. Martens, M. V. D. van den Bossche

Journal of Clinical Sleep Medicine December 31, 2024 DOI: 10.5664/jcsm.11540 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population 64-year-old female with new-onset visual hallucinations
Key findings Argues that narcolepsy type 1 can have a very late onset, as late as the sixth decade, and should be considered in older adults with new neuropsychiatric symptoms.

Abstract

Narcolepsy type 1 is a clinical syndrome defined by recurrent episodes of excessive daytime sleepiness, episodes of cataplexy, hypnagogic hallucinations, and sleep paralysis. Symptoms typically manifest in the second or third decade with another small peak in the fourth decade. In this report we describe the case of a 64-year-old female presenting with new-onset visual hallucinations as the main complaint. Eventually diagnosis of narcolepsy type 1 was confirmed by determination of orexin levels (hypocretin-1) on cerebrospinal fluid. This case illustrates that age of onset of narcolepsy type 1 can be as late as the sixth decade in life and that narcolepsy type 1 should be considered as a possible though rare diagnosis in older adults presenting with new onset neuropsychiatric symptoms like visual hallucinations. Martens J, Van Den Bossche M. Very late onset narcolepsy type 1: a case report and review of the literature. J Clin Sleep Med. 2025;21(5):917–929.