Neuromyelitis optica presenting as narcolepsy: a case report
The present case has been reported in the Annals of Indian Academy of Neurology.

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness. It can be either primary or symptomatic due to other neurologic disorders. Neuromyelitis optica (NMO) is an inflammatory demyelinating disorder in which symptomatic narcolepsy is being described as one of the core clinical features.

The authors report a case of a patient with NMO who presented with narcolepsy. Signal changes on magnetic resonance imaging in hypothalamus and other periventricular regions of high aquaporin-4 expression should prompt considering NMO as diagnosis.

Serum anti-aquaporin-4 IgG antibody testing should be done in such cases, and appropriate treatment should be initiated to prevent further neurological worsening and relapses.

A 20-year-old female presented with complaints of excessive sleep for 10 days. Her sleep duration gradually increased to 16–17 h/day and later to 20–22 h/day, getting up only for her daily needs. Three days after the onset of hypersomnolence, she developed swaying while walking which gradually progressed to require support while walking.

Five days after the initial symptom, the patient developed double vision, which was binocular and more for distant objects.

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