Diagnosis of Narcolepsy

Diagnosis of Narcolepsy

I was diagnosed with Narcolepsy by a procedure known as EEG (electroencephalogram) which seems to be a pocket friendly test in a government institution, Kenyatta National Hospital in 2007. Back then only KNH had an EEG machine

EEG services are available in every Level 5 hospitals in Kenya and one can be diagnosed with the help of a Psychiatrist. Insist to be seen by a psychiatrist and explain your Sleep Symptoms.

Currently, we have several clinics that offer Sleep Study Tests in Nairobi, i.e:

  1. German Medical Centre
  2. Sleep Diagnostic and Treatment Center Nairobi
  3. www.nairobientclinic.com
  4. Brain and Nerve Diagnostic Services

Enough about me, on average it takes 10 years from onset of symptoms to an official diagnosis of narcolepsy and visits to approximately 6 different specialists. Prior to diagnosis, it is not uncommon for people to be misdiagnosed with other sleep disorders, depression, psychiatric conditions, ADHD and even epilepsy. 

A comprehensive medical history, examination, and use of a sleep journal are key components when diagnosing narcolepsy. A full medical history and physical examination can provide possible alternatives to excessive sleepiness. The sleep journal may assist the physician in reviewing symptoms and symptom onsets, with cataplexy being most notable. There are 2 diagnostic tests commonly utilized in determining the existence of narcolepsy.

Polysomnogram – An overnight polysomnogram or sleep study is an extensive diagnostic tool for physicians. Electrodes applied to the head record brain wave activity as the person goes into and out of different stages of sleep. Other electrodes record eye movements, existence of snoring, breathing patterns and muscle activity that may occur while the person sleeps. Physicians use the polysomnogram to rule out other disorders such as obstructive sleep apnea or primary snoring.

Multiple Sleep Latency Test (MSLT) – A multiple sleep latency test occurs the day following an overnight sleep study. The test begins approximately two hours following the conclusion of the polysomnogram. While most of the electrodes and wires from the previous night are removed, those recording brain wave activity remain to determine sleep onset.

An MSLT consists of five napping opportunities throughout the day spaced at two hour intervals. The purpose is to monitor the length of time to sleep onset and REM onset. If no sleep is observed, the nap concludes after 20 minutes. If sleep does occur, sleep onset time is noted and the nap concludes 15 minutes after sleep onset. Sleep onset averaging less than eight minutes over the course of the MSLT indicates excessive daytime sleepiness. REM onset that occurs in at least two of the nap opportunities provides a clear picture for the diagnosing physician.

In some cases, physicians may request a sample of cerebrospinal fluid to be analyzed for the amount of hypocretin present. This is done by lumbar puncture or spinal tap to remove some of the cerebrospinal fluid. Low levels of hypocretin commonly indicate narcolepsy.

Courtesy: tuck.com/narcolepsy

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