Silber et al developed and validated criteria for the diagnosis of narcolepsy suitable for research studies. The authors are from the Mayo Clinic.
Parameters:
(1) history of excessive daytime sleepiness
(2) history of cataplexy
(3) mean initial sleep latency on multiple sleep latency test (MSLT)
(4) sleep onset rapid eye movements (SOREMP) on multiple sleep latency test
(5) sleep onset rapid eye movements on nocturnal polysomnogram (PSG)preceding the multiple sleep latency test
(6) apnea-hypopnea index (AHI) on nocturnal polysomnogram preceding the multiple sleep latency test
(7) documented episode of cataplexy (witnessed by physician or recorded on videotape during sleep studies
where:
• Sleep studies involve a nocturnal polysomnogram one night, with a multiple sleep latency test done on the following night under standard conditions. The total sleep time should be >= 6 hours on the preceding night polysomnogram.
• Cataplexy = bilateral weakness of brief duration brought on by emotion
Categories:
(1) definite narcolepsy (A)
(2) probable narcolepsy (B): divided into subgroups B1 and B2
(3) probable narcolepsy (C): clinical findings with no or inadequate sleep studies performed.
|
Parameters |
A |
A |
A |
|
excessive daytime sleepiness |
Y |
Y |
Y |
|
history of cataplexy |
Y |
Y |
Y |
|
mean initial sleep latency on MSLT, in minutes |
< 8 |
< 8 |
NA |
|
SOREMP on MSLT |
>= 2 |
1 |
NA |
|
SOREMP on preceding PSG |
NA |
1 |
NA |
|
AHI per hour on preceding PSG |
< 10 |
< 10 |
NA |
|
documented episode of cataplexy |
NA |
NA |
Y |
|
Parameters |
B1 |
B2 |
B2 |
C |
|
excessive daytime sleepiness |
Y |
Y |
Y |
Y |
|
history of cataplexy |
Y |
N |
N |
Y |
|
mean initial sleep latency on MSLT, in minutes |
< 8 |
< 8 |
< 8 |
not done |
|
SOREMP on MSLT |
0 or 1 |
>= 2 |
1 |
not done |
|
SOREMP on preceding PSG |
0 or 1 |
NA |
1 |
not done |
|
AHI per hour on preceding PSG |
< 10 |
< 10 |
< 10 |
not done |
|
documented episode of cataplexy |
NA |
NA |
NA |
not done |
Performance:
• There is no gold standard for the diagnosis of narcolepsy.
• High inter-rater reliability (0.97).
• Correlates with HLA typing for DQB1*0602.
Specialty: Neurology
