A Szucs1, J Janszky, A Holló, G Migléczi, P Halász. 1. Department of Neurology, National Institute of Psychiatry and Neurology, Budapest, Hungary. szucsan@bakats.tvnet.hu
Abstract
OBJECTIVE: To describe psychosis-like hallucinatory states in unrecognized narcolepsy. METHOD: Two patients with hypnagogic/hypnapompic hallucinations are presented. RESULTS: Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy. CONCLUSION: We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.
OBJECTIVE: To describe psychosis-like hallucinatory states in unrecognized narcolepsy. METHOD: Two patients with hypnagogic/hypnapompic hallucinations are presented. RESULTS: Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy. CONCLUSION: We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.
Authors: Erin Wamsley; Claire E H M Donjacour; Thomas E Scammell; Gert Jan Lammers; Robert Stickgold Journal: Sleep Date: 2014-02-01 Impact factor: 5.849
Authors: Francesca Canellas; Ling Lin; Maria Rosa Julià; Antonio Clemente; Cristofol Vives-Bauza; Hanna M Ollila; Seung Chul Hong; Susana M Arboleya; Mali A Einen; Juliette Faraco; Marcelo Fernandez-Vina; Emmanuel Mignot Journal: J Clin Sleep Med Date: 2014-09-15 Impact factor: 4.062