60. Hallucinations with sexual context as manifestation of narcolepsy without cataplexy. Case report

Abstract

Objective Description of clinical case of hypnagogic visual hallucinations and narcolepsy without cataplexy. Case report Female 24 years old, at age 8 begins with auditory and visual hallucinations, 3 min long (6 month). She was diagnosed as epileptic and antiepileptic handled without improvement. At 18 years of age, begins with excessive daytime sleepiness, feeling unable to move in bed wanting to wake up and start the dream hallucinations consisting in that she was raped and fought against their aggressors; these episodes became frequent after 22 years. Neurological examination, EEG and brain MRI were normal. Epilepsy and psychiatric disorders were ruled out. Narcolepsy was suspected, but PSG was normal. Then multiple sleep latency test was compatible with narcolepsy without cataplexy. Currently she is under modafinil and antidepressant treatment with decrements un hallucinations and improved alertness during the day. Comment There are scarce cases in the literature with hypnagogic hallucinations with sexual contexts, as a manifestation of narcolepsy. Faced with a poor clinical symptomatology, epilepsy or psychiatric illness can be misdiagnosed, so it is important to know their existence and Para clinical findings may help to integrate a correct diagnosis and treatment.