Narcolepsy Type 1 and XXXX : Diagnostic and Therapeutic Challenges in Dual Cases.

@entity1 @entity410 @entity63757 @entity2725 @entity15221 @entity302 @entity3762 @entity25 @entity1319
STUDY OBJECTIVES: The aim of this study is to describe the possible co-occurrence of @entity63757 and generalized @entity302 , focusing on diagnostic challenge and safety of dual treatments. METHODS AND RESULTS: Four @entity1 with comorbidity for @entity63757 and @entity3762 are reported: in three cases the onset of @entity302 preceded @entity63757 appearance, whereas in one case @entity302 spells onset was subsequent. @entity1 presented with absences, myoclonic and tonic-clonic @entity410 type: in the @entity1 with @entity410 the dual pathology was easily recognized, in the other cases the first diagnosis caused the comorbid disease to be overlooked, independent of the time-course sequence. All four @entity1 underwent neurological examination, video-electroencephalogram during which ictal and interictal @entity302 discharges were recorded, and sleep polysomnographic studies. Repeated sleep onset @entity1319 periods (SOREMPs) were documented with the multiple sleep latency test (MLST) in all the four cases. All @entity1 had unremarkable brain magnetic resonance imaging studies and cerebrospinal hypocretin-1 was assessed in two @entity1 , revealing undetectable levels. The association of antiepileptic drugs and substances currently used to treat @entity63757 , including @entity15221 , was effective in improving @entity410 , @entity25 , and @entity2725 . CONCLUSIONS: @entity63757 may occur in association with @entity3762 , leading to remarkable diagnostic and therapeutic challenges. Electrophysiological studies as well as a comprehensive somnologic interview can help confirm the diagnosis in @entity1 with ambiguous neurological history. @entity15221 in combination with antiepileptic drugs is safe and effective in treating @entity25 .
