Congiu, P., Puligheddu, M., Capodiferro, A. M., Falqui, S. G., Tamburrino, L., Figorilli, M., Plazzi, G., & Gagliano, A. (2024). Narcolepsy and pediatric acute-onset neuropsychiatric syndrome: A case report that suggests a putative link between the two disorders. Sleep Medicine, 121, 370–374. https://doi.org/10.1016/j.sleep.2024.06.02
- Case report of a 13-year-old boy diagnosed with both NT1 and PANS, suggesting a shared neuroimmune mechanism.
- Abrupt onset of vocal tics, OCD symptoms, anxiety, regression, school decline, and sleep disturbance.
- Progressed to daytime sleepiness, spontaneous falls, confusion, and cataplexy-like episodes.
- Elevated ASLO titer indicated prior streptococcal exposure; MRI/EEG normal; sleep study confirmed NT1.
- HLA DQB1*06:02 negative — rare in NT1 but documented.
- No clinical improvement with steroid immunotherapy.
- Significant improvement with narcolepsy and psychiatric medications, including remission of cataplexy.
- Authors propose NT1 and PANS may exist on a post-infectious autoimmune spectrum involving orexin (sleep/cataplexy) and dopamine (tics/OCD/anxiety) dysfunction.
Gabriella True
