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ISSN: 1935-1232 (P)

ISSN: 1941-2010 (E)

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Abstract

The Differential Diagnosis of Excessive Daytime Sleepiness and Cognitive Deficits in a Patient with Delirium,Schizophrenia and Possible Narcolepsy: A Case Report

Author(s): David R. Spiegel , Parker W. Babington , Ariane M. Abcarian , Christian De Filippo

Narcolepsy and schizophrenia are disorders which share common features of negative symptoms, excessive daytime sleepiness and cognitive deficits. Presented here is a case report of a fifty-nine year old man with a past medical history of schizophrenia who was evaluated for suspected symptoms of delirium. After an electroencephalogram was performed with surprising results, the patient’s differential diagnosis included schizophrenia with comorbid narcolepsy. We present emerging evidence that excessive daytime sleepiness and attentional deficitsin both narcolepsy and schizophrenia may share a common pathophysiological pathway through orexin deficiency and its effects on the dopamine system. Finally, we discuss the potential for modafinil as a treatment for excessive daytime sleepiness and attentional problems in schizophrenia and narcolepsy