Type 1 narcolepsy without cataplexy and treatment progress: a case report

Narcolepsy is a sleep disorder with the main manifestations of excessive daytime sleepiness, cataplexy, sleep paralysis, sleep hallucinations, and nighttime sleep disturbance. It is still not fully recognized by clinicians, and many patients are often misdiagnosed with epilepsy, syncope, or mental disorders. In the present study, we report the first case of narcolepsy diagnosed at the district, with a complete medical history, objective examinations, and cerebrospinal fluid and hematological tests, but no cataplexy. Mutiple sleep latentcy test (MSLT) showed that the average sleep latency was 3.1 min, and abnormal REM sleep episodes were detected in 4 naps. The average REM latency was 1.3 min. We review the knowledge and researches on this disease in Mainland China in the past 10 years. Data from China in 2014 showed a significant increase in the incidence of narcolepsy in 2011 after the H1N1 epidemic in China in 2009. Despite the low incidence rate, diagnosis of narcolepsy is still confusing and needs clinicians' attention. Whether the incidence of narcolepsy may increase after covid19 remains to be observed. So far, there is no clear evidence to support immunotherapy. In conclusion, further studies are needed to verify more treatments and improve the patient's life quality.