Wang Mei-Ou, Ma Jing, Li Si-Xun, Zhang Lan
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):444-446. doi: 10.12182/20230360104.
We present the case of an 18-year-old male patient who had narcolepsy type 1 and comorbid schizophrenia. The patient's first symptom was mainly excessive daytime sleepiness, which was followed by psychotic symptoms, including hallucinations, delusions, and abnormal speech and behaviors. After admission to the hospital, the patient underwent a number of ancillary tests. Multiple sleep latency test (MSLT) showed that the mean sleep latency was 2 min and the hypocretin-1 was found to be 90.56 pg/mL. The patient was diagnosed with: 1) schizophrenia; 2) narcolepsy. After receiving antipsychotic drugs and behavioral therapy, the patient's hallucinations and abnormal speech and behaviors disappeared, and delusions and excessive daytime sleepiness decreased significantly. The symptoms and manifestations of narcolepsy type 1 overlaps with those of schizophrenia, which may lead to misdiagnosis and underdiagnosis in clinical practice. The case is presented with a view to providing a reference for the clinical diagnosis and treatment of narcolepsy type 1 with comorbid schizophrenia.
我们报告一例18岁男性患者,患有1型发作性睡病并合并精神分裂症。患者的首发症状主要是白天过度嗜睡,随后出现精神病性症状,包括幻觉、妄想以及言语和行为异常。入院后,患者接受了多项辅助检查。多次睡眠潜伏期试验(MSLT)显示平均睡眠潜伏期为2分钟,脑脊液下丘脑分泌素-1水平为90.56 pg/mL。患者被诊断为:1)精神分裂症;2)发作性睡病。接受抗精神病药物和行为治疗后,患者的幻觉以及言语和行为异常消失,妄想和白天过度嗜睡明显减轻。1型发作性睡病的症状和表现与精神分裂症有重叠,这可能导致临床实践中的误诊和漏诊。本文报告该病例旨在为合并精神分裂症的1型发作性睡病的临床诊断和治疗提供参考。