PMID- 37503483
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230729
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 6
DP  - 2023 Jun
TI  - A Rare Presentation of Narcolepsy With Cataplexy After Vaccines in a Genetically 
      Susceptible Elderly Woman: A Case Report.
PG  - e40997
LID - 10.7759/cureus.40997 [doi]
LID - e40997
AB  - Observing cataplexy episodes during an office visit is extremely rare as they are 
      usually triggered by laughter or emotional stress. Narcolepsy usually occurs in 
      the younger population. We report a case of a 65-year-old Caucasian female with a 
      past medical history of obesity who developed excessive daytime sleepiness, 
      fatigue, and sleep attacks five weeks after getting influenza and pneumococcal 
      vaccines. The presentation of cataplexy was atypical. Several episodes of 
      cataplexy were observed during the office visit without any emotional trigger. 
      Further workup, including polysomnography (PSG), was positive for obstructive 
      sleep apnea, controlled with continuous positive airway pressure (CPAP) use. 
      Later, she had PSG with CPAP use, which optimally controlled obstructive sleep 
      apnea, followed by multiple sleep latency tests (MSLT) with CPAP use. It was 
      positive for narcolepsy with a mean sleep latency of 1.6 minutes with sleep onset 
      rapid eye movement (REM) in five out of five naps. Her cerebrospinal fluid (CSF) 
      hypocretin level was extremely low at 50 pg/ml, usually seen in narcolepsy with 
      cataplexy. She was also positive for human leukocyte antigen (HLA) DBQ1*06:02. 
      The diagnosis of narcolepsy with cataplexy was made, which improved with 
      medications for narcolepsy.
CI  - Copyright (c) 2023, Verma et al.
FAU - Verma, Ram K
AU  - Verma RK
AD  - Sleep Medicine, Parkview Health System, Fort Wayne, USA.
FAU - Prasad, Vinita
AU  - Prasad V
AD  - Psychiatry, Parkview Health System, Fort Wayne, USA.
FAU - Rath, Subhendu
AU  - Rath S
AD  - Department of Neurology, Virginia Commonwealth University School of Medicine, 
      Richmond, USA.
FAU - Monga, Varun
AU  - Monga V
AD  - Psychiatry, Banner Health, Phoenix, USA.
FAU - Dhillon, Gagandeep
AU  - Dhillon G
AD  - Internal Medicine, Baltimore Washington Medical Center (BWMC), Glen Burnie, USA.
LA  - eng
PT  - Case Reports
DEP - 20230626
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10371286
OTO - NOTNLM
OT  - cataplexy
OT  - elderly
OT  - genetically
OT  - narcolepsy
OT  - vaccines
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/28 06:43
MHDA- 2023/07/28 06:44
PMCR- 2023/06/26
CRDT- 2023/07/28 04:31
PHST- 2023/06/26 00:00 [accepted]
PHST- 2023/07/28 06:44 [medline]
PHST- 2023/07/28 06:43 [pubmed]
PHST- 2023/07/28 04:31 [entrez]
PHST- 2023/06/26 00:00 [pmc-release]
AID - 10.7759/cureus.40997 [doi]
PST - epublish
SO  - Cureus. 2023 Jun 26;15(6):e40997. doi: 10.7759/cureus.40997. eCollection 2023 
      Jun.