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VOLUME 15 , ISSUE 1 ( January-March, 2020 ) > List of Articles
Dipti Gothi, Agarwal Mohit, Deshmukh Ishani
Keywords : Iron deficiency, Narcolepsy with cataplexy, Polysomnography, Restless leg syndrome
Citation Information : Gothi D, Mohit A, Ishani D. Three Narcoleptics with Restless Leg Syndrome. Indian Sleep Med 2020; 15 (1):5-8.
License: CC BY-NC 4.0
Published Online: 00-03-2020
Copyright Statement: Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.
We are reporting the third largest Indian narcolepsy case series. Among 250 consecutive patients referred to our sleep center for polysomnography (PSG), 3 of them were diagnosed to have narcolepsy with cataplexy (NC). They had history of excessive daytime sleepiness (EDS) and sudden loss of muscle power leading to fall without alteration in consciousness. Their polysomnographies did not have obstructive sleep apnea (OSA). All of them had multiple sleep latency test (MSLT) showing sleep latency of less than 8 minutes and two sleep-onset rapid eye movement period (SOREMP). Since narcolepsy patients commonly have restless leg syndrome (RLS), RLS was studied in detail in them. All our patients with NC had RLS. The patients from Western countries with NC and RLS have normal or high iron level. But the serum iron level was low in two patients and normal in one patient. The management of RLS secondary to iron deficiency is thus an important component of NC in Indian patients. Key messages: • Clinical history is very important for suspicion of narcolepsy. • Multiple sleep latency test is diagnostic of narcolepsy in the current clinical context. • Restless leg syndrome is diagnosed on history alone. Since it occurs commonly with narcolepsy, history of RLS in important in narcolepsy patients. • Iron deficiency can also be causative factor for RLS in narcolepsy in Indian patients though it is reported to be due to narcolepsy itself in Western counterparts. • Modafinil alone is not useful in the treatment of narcolepsy; a tailor-made pharmacological and supportive non-pharmacological approach is essential.
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