Hypnogram narcolepsy1/20/2024 ![]() She was referred to the neurology department to evaluate any underlying neurologic problems. The cardiac evaluation revealed normal electrocardiogram (EKG), 24-hour Holter recording, treadmill test and 2D echocardiogram. There were no warning signs such as dizziness, hallucination or autonomic symptoms before the attack started. However, the attacks usually occurred when she stood up, walked or spoke to people. She denied any emotional trigger factor for sudden fall, such as laughter, excitement, surprise and anger. Its frequency varied from five to seven episodes per day, increasing gradually. The duration of attacks was usually less than a minute. Usually, only her lower limbs were involved in the attacks, but sometimes there was a complete weakness that involved both arms and face too. However, she started to experience drop attacks that made her abruptly fall down and injure herself, without any alteration of consciousness. She also denied any sleep paralysis and hypnagogic hallucination, but acknowledged fragmented night-time sleep. She denied any subjective daytime sleepiness since then. These symptoms lasted three months, and then disappeared. Eight months back, there was a sudden development of excessive daytime sleepiness, along with long sleep durations (more than 12 hours a day). A 58-year-old Korean female presented with a 5-month history of recurrent drop attack. ![]()
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