Two Cases of Narcolepsy Patient Portraying a Tendency of a Dull Learning Ability and Mistaken as an Idle Student

Lee, S H; Kim, S K; Kim, L; Chung, Y C; Suh, K Y

Abstract

Sleepiness is associated with many different conditions and, as a neglected topic, it can be the cause of serious psychological and social disadvantages. In the aspect of learning, additional problems may arise from poor progress in school caused by the effect of sleepiness on concentration, memory, and other cognitive functions. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not a rarity, especially in young people. The non-specific nature of early features of narcolepsy, combined with very limited awareness that the condition can start in various ways, leads to many misinterpretations. Misinterpretation of narcolepsy symptoms is not confined to the medical profession. Teachers may well be critical of a student with narcolepsy because of their perception of narcolepsy symptoms as laziness, poor motivation, or difficult behavior and dull learning ability. Inappropriate reactions by patients, teachers, and peers, based on misinterpretation of narcolepsy symptoms or the patient's reactions to them, make a difficult situation worse. Especially in Korea, where schooling is focused on college entrance examinations, the problem is very serious and intensified by inappropriate or delayed diagnosis and treatment. Therefore, psychiatrists should be aware that narcolepsy in young adolescents is not rare and that they need to be familiar with its clinical features in both its classic and less obvious forms. Narcolepsy should be suspected if a adolescent's excessive sleepiness can not be explained in other ways. Therefore, we report on two patients who portray the tendency of dull learning ability and are mistaken as idle students. We diagnosed narcolepsy through polysomnography and multiple sleep latency testing. We treated the students with methylphenidate and pemolin. The students showed improvement in learning ability and were able to adapt better to school.