0852 Narcolepsy Type 1 in a Pediatric Patient with Temporal Lobe Epilepsy

Abstract Introduction Narcolepsy type-1 is clinically characterized by irrepressible daytime sleepiness and REM-sleep dissociation, including cataplexy. Cataplexy usually manifests as episodes of brief, symmetrical sudden loss muscle tone with retained consciousness. It may be difficult to distinguish from seizure activity they share overlapping features. We discuss a pediatric patient temporal lobe epilepsy co-occuring Type 1. Report Cases: A 17-year-old boy obesity history focal secondary intracranial hemorrhage in the neonatal period status-post right parieto-occipital resection at age 11, presented worsening fall feeling imbalance Following surgery, his seizures improved, but he was having excessive sleepiness. At 13, started experiencing slurred speech, imbalance, “body heaviness tongue heaviness” occasional falls. He denied consciousness, body shaking, stiffening, or incontinence. 17, medical attention due increasing frequency such episodes. Physical exam significant for BMI 42.7 kg/m , Mallampati 4, tonsils 3+ bilaterally, homonymous hemianopia. Epworth Sleepiness Scale: 22/24. Video EEG negative epileptiform discharges despite occurrence above-mentioned clinical suspicion Narcolepsy. Polysomnography revealed sleep latency 0 minutes, REM 2.6 mild OSA. Toxicology screen negative. MSLT showed mean 1.2 minutes 3 SOREMPs. CSF orexin could not obtained technical constraints. diagnosed on Venlafaxine Methylphenidate resultant improvement both sleepiness, severity However, persisted, prompting repeat video which demonstrated left activity. Anti-epileptic regimen optimized sensation imbalance. Conclusion Temporal Type-1 can have features that make it between two. While exceedingly rare, two entities co-occur. Diagnostic therapeutic management require coordination Sleep Medicine Neurology. PSG, MSLT, Orexin clarify diagnosis narcolepsy, neurologic work up should pursued if symptoms are completely attributable Support (If Any)