Previously well man presented to his GP with hypersomnolence, cataplexy, vertical gaze palsy and hyperphagia. Sleep studies supported a narcolepsy diagnosis, which improved minimally with pharmacotherapy. Over the next year, he deteriorated, experiencing memory problems, choreoathetosis, myoclonus, ataxia and dysarthria. He then presented in a confusional state characterized by psychosis and profound hypersomnolence.

Patient Data

Age: 35
Gender: Male