Case report: early onset narcolepsy initially misdiagnosed as obstructive sleep apnea syndrome

Background. Narcolepsy is a chronic neurological syndrome, which is characterized by excessive sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis during the rapid eye movement period of sleep. This disease is commonly diagnosed within adulthood. However, the first symptoms often appear in childhood and/or adolescence. Pediatric cases of narcolepsy generally remain unrecognized and undiagnosed. Clinical heterogeneity, prolonged onset and diverse symptoms contribute to the delay in diagnosis and treatment in childhood. Case. This report describes a case of narcolepsy in an 8,5-year-old male patient who was misdiagnosed as obstructive sleep apnea syndrome and many other diagnoses at different hospitals over a period of 3 years before the correct diagnosis was made. Conclusions. Narcolepsy in children is a rare neurological syndrome, which can occur with uncommon and atypical clinical presentations. In our case report we aimed to highlight pediatric narcolepsy, which could help to make more appropriate approaches and prevent misdiagnoses or diagnosis delay in these cases.