Pseudo status cataplecticus in narcolepsy type 1

Abstract

The rare constellation of multiple episodes of cataplexy that are refractory to therapy is called status cataplecticus. We describe a young adult with known narcolepsy type 1 who reported a marked exacerbation of her symptoms that was initially suspicious for status cataplecticus. Neurological evaluation, polysomnography, and additional history revealed that the spells were not consistent with cataplexy, but rather with a somatoform disorder. The case highlights the importance of considering psychosomatic factors in narcolepsy type 1 when presumed cataplexy remains suboptimally controlled despite adequate dosing with appropriate medications.