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Narcolepsia

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  • Theory
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Last reviewed: 10 Aug 2025
Last updated: 31 Jul 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • sonolência diurna excessiva
  • cataplexia
  • alucinações hipnagógicas/hipnopômpicas
  • paralisia do sono
Full details

Other diagnostic factors

  • fadiga crônica ou cansaço
  • baixo desempenho no trabalho
  • falta de memória e baixa concentração
  • acidentes de carro
  • fala indistinta
  • visão turva
  • padrão respiratório irregular
  • ataques de sono
  • sono noturno fragmentado
  • sintomas de outros distúrbios do sono
  • obesidade
  • status cataplecticus
  • hepatomegalia
  • paresia
Full details

Risk factors

  • baixa concentração de hipocretina no líquido cefalorraquidiano
  • antígeno leucocitário humano (HLA)-DQB1*0602
  • Síndrome de Prader-Willi
  • doença de Niemann-Pick tipo C
  • ligação com o 4p13-q21
  • genes no cromossomo 6 ou cromossomo 21
  • tumores hipotalâmicos
  • infarto/hemorragia hipotalâmica
  • trauma cranioencefálico
  • infecção do sistema nervoso central
  • Malformações arteriovenosas no sistema nervoso central
  • esclerose múltipla
  • distrofia miotônica
Full details

Diagnostic tests

1st tests to order

  • actigrafia e diário do sono
  • polissonografia noturna
  • teste múltiplo de latência do sono (TMLS)
Full details

Tests to consider

  • tipagem HLA (antígeno leucocitário humano)
  • nível de hipocretina-1 no líquido cefalorraquidiano
  • teste da manutenção da vigília
Full details

Treatment algorithm

ONGOING

adultos com sonolência diurna excessiva (SDE)

adultos com cataplexia

crianças com sonolência diurna excessiva (SDE)

crianças com cataplexia

Contributors

Authors

Octavian C. Ioachimescu, MD, PhD
Octavian C. Ioachimescu

Associate Professor

Emory University

Atlanta VA Medical Center

Atlanta

GA

Disclosures

OCI is an editor of a book cited in this topic.

Peer reviewers

Kumaraswamy Budur, MD

Medical Doctor

Sleep Disorders Center

Department of Psychiatry

Cleveland Clinic

Cleveland

OH

Disclosures

KB declares that he has no competing interests.

Seiji Nishino, MD, PhD

Associate Professor

Psychiatry and Behavioral Science

Stanford University School of Medicine

Stanford

CA

Disclosures

SN declares that he has no competing interests.

Kingman P. Strohl, MD, FCCP

Professor of Medicine

Director

Center for Sleep Disorders Research

Professor of Anatomy

Department of Medicine

Case Western Reserve University

Cleveland

OH

Disclosures

KPS declares that he has no competing interests.

Paul Reading, MBBS

Consultant Neurologist

James Cook University Hospital

Middlesbrough

UK

Disclosures

PR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Sleep Medicine. The AASM International classification of sleep disorders – third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].Full text

Smith MT, McCrae CS, Cheung J, et al. Use of actigraphy for the evaluation of sleep disorders and circadian rhythm sleep-wake disorders: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2018 Jul 15;14(7):1231-7.Full text  Abstract

Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021 Sep 1;17(9):1881-93.Full text  Abstract

Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. Eur J Neurol. 2021 Sep;28(9):2815-30.Full text  Abstract

Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021 Sep 1;17(9):1895-945.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Apneia do sono não tratada
    • Movimentos periódicos dos membros durante o sono
    • Síndrome das pernas inquietas (SPI)
    More Differentials

  • Guidelines

    • Recommended protocols for the multiple sleep latency test and maintenance of wakefulness test in children: guidance from the American Academy of Sleep Medicine
    • The AASM manual for the scoring of sleep and associated events
    More Guidelines

  • Patient information

    Apneia do sono em adultos (obstrutiva)

    Insônia

    More Patient information
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