For 20 years she had been suffering from sudden falls without loss of conciousness 3-4 times a month after which she could not move her body for approximately 30 seconds following a a complete recovery in 10 minutes. Sometimes these episodes were triggered by emotions. She experienced excessive daytime sleepiness, but had trouble sleeping at night and was subjected to sleep paralysis with hypnagogic and hypnopompic hallucinations especially when waking up in the morning or during the night.A hypothesis of narcolepsy with cataplexy (NT1) was presented.The following investigations were performed: electroencephalogram and magnetic resonance imaging of the brain revealed no abnormalities. Lumbar puncture showed no signs of infection. Levels of CSF hypocretin on the other hand were decreased (82 pg/ml). NT1 is characterized by a low hypocretin level (b110 pg/ml). She tested positive for both narcolepsy related HLA allels DQB1*06:02 and DQA1*01:02. She was diagnosed with narcolepsy type 1. She was prescribed 200 mg modafinil and 150 mg venlafaxine daily. That has been reducing her daytime sleepiness, cataplexy and sleep paralysis.
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