Characteristics of narcolepsy according to the age of diagnosis

Introduction To conduct a descriptive analysis between narcoleptic patients diagnosed before and after 18 years. Materials and methods Data extracted from the National French multicentre research program on narcolepsy (PHRC AOM07-138), 23 pediatric patients from the Lyon’s center were added to this data base. Clinical and electrophysiological characteristics were compared between de novo patients diagnosed before ( n  = 59) and after 18 years ( n  = 108). Results Mean ages ± SD at diagnosis were respectively 11.7 pm 2.9 in pediatric (PP) vs 33.5 ± 14.3 years in adult (AP) patients. Sleepiness appeared earlier in children (10 ± 2.8 vs 25 ± 12.5 years, p p  =  0.01). Cataplexy were reported in 84% of PP vs 49% of AP ( p p  = 0.003), but no difference for hypnagogic hallucinations (44.1% vs 50.9%). HLA DQB1*0602 was found in 94.9% of the PP vs 54.6% in AP ( p p p  = 0.003). On PSG, PP had higher TST ( p p  = 0.045), more N3% ( p  = 0.005) and lower AHI ( p  = 0.019) than AP. On MLST, PP had more SOREM than AP ( p  = 0.02). No differences were found between PP and AP for sleep latencies on PSG or MLST, for EPWORTH and ISI scores. On Conners RS-R (>75), ADHD symptoms were only found in PP (5.13% vs 0%, p p r  = −0.57, p r  = −0.43, p r  = −0.46, p r  = −0.31, p  = 0.001). Conclusion The clinical presentation with obesity and ADHD was more marked in narcoleptic patients diagnosed during pediatric age, which could explain the short diagnosis delay. However, adult patients had lower QL than PP patients. We recommend a prompt diagnosis and a more thorough assessment and long term management of psychological health in this population. Acknowledgements The study was financed in part by a Brazilian Grant “CAPES” to Clara Inocente and a French Grant “PHRC AOM07-138” from the French Health Ministry to Isabelle Arnulf. Patricia Franco and Isabelle Arnulf benefit from a grant “INTERFACE-INSERM-Hopitaux” to finance their research.